Background: As a multisystem autoimmune disease, Systemic Lupus Erythematosus
(SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate
the fetal and maternal outcomes of Iranian women with SLE.
Methods: Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez
hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz
University of Medical Science, were reviewed during April 2012 and March 2016.
Results: The mean age of the patients was 29.28±4.6 years and mean disease duration was 5.09±4.2
years. Live birth rate was 83.3% after exclusion of elective abortions. There were 50 live births, 3
neonatal deaths, 3 spontaneous abortions and 7 stillbirths. 9 (15%) women developed preeclampsia
and there was 1 (1.6%) case of HELLP syndrome. Lupus flares occurred in 27 (45%) patients during
pregnancy. Preterm delivery occurred in 11.6% of pregnancies. Skin and joints were the most
frequently affected organs. Patients with previous lupus nephritis (n=18) were associated with a
higher risk of maternal complication, but fetal outcomes were similar in both groups. Cesarean rate
was about 66%, mostly related to fetal indications (50%).
Conclusion: Pregnancies in most women with pre-existing SLE can now be managed with successful
results although presence of previous lupus nephritis is still a major risk factor for adverse maternal
outcomes. In our study, fetal outcome was not different between patients with lupus nephritis
compared with the patients without nephritis who were under treatments. Hence, to achieve favorable
long-term results, we recommend regular multispecialty treatment approaches and progestational
counseling for women with SLE.