系统性红斑狼疮合并妊娠145例次母婴结局及临床预测因素

目的 总结系统性红斑狼疮(SEE)合并妊娠的母婴结局,分析妊娠期问SLE病情恶化、胎儿丢失、不良胎儿结局的预测因素.方法 回顾性分析1990年1月至2007年12月在北京协和医院和深圳市人民医院住院的SEE合并妊娠临床资料.结果 120例SEE合并妊娠145例次,妊娠时年龄18～4I岁,平均(28±4)岁,SEE病程0.5～18年,平均(5±4)年.共有46例次(31.7%)妊娠期间SLE病情恶化,主要在妊娠中、晚期,常累及皮肤黏膜及关节肌肉系统.妊娠期间SEE病情恶化与妊娠前病情活动及低补体血症有关(P＜0.05).妊娠前病情活动组子痫前期及子痫的发生率明显高于病情稳定组(P＜0.01).共成功分娩104例次(71.7%,其中双胞胎2例),18例次自然流产(12.4%),10例次死产(6.9%),13例次治疗性流产(9.0%).早产36例次(34.6%),新生儿出现宫内生长迟缓(IUGR)37例次(35.6%).胎儿丢失(包括自然流产及死产)的危险因素有合并抗磷脂综合征(APS)、妊娠前病情活动(P＜0.05);引起不良胎儿结局(包括早产或IUGR)的危险因素有妊娠前抗dsDNA抗体阳性、泼尼松剂量≥10 mg/d及妊娠期间SLE病情恶化(P＜0.05).21例患者行胎盘病理学检查,其中13例发现胎盘组织血管壁纤维素样坏死、梗死表现,该组患者抗磷脂抗体阳性率明显高于胎盘病理基本健康组(P＜0.05).结论 妊娠前SEE病情活动、低补体血症与SEE妊娠期间SEE病情恶化相关.合并APS、妊娠前病情活动使胎儿丢失的危险性增加,而妊娠前抗dsDNA抗体阳性、泼尼松剂量≥10 mg/d及妊娠期间SLE病情恶化使不良胎儿结局的危险性增加.     

系统性红斑狼疮合并妊娠患者孕期病情的变化及其对母儿结局的影响

目的 探讨系统性红斑狼疮(SLE)合并妊娠孕妇孕期病情的变化及其对母儿结局的影响.方法 选择44例合并SLE患者的46次妊娠,分析孕期SLE病情的活动情况及其对母儿结局的影响,找出与母儿不良预后相关的危险因素.采用t检验、X2检验或Fisher精确概率法及多因素非条件Logistic回归分析等方法进行统计学分析.结果 ①孕期出现SLE病情活动19例次(活动组);无SLE活动27例次(稳定组).SLE的活动率在孕前病情稳定的患者中为16％(5/32),在孕前病情不稳定的患者中为100％( 8/8),2组相比差异有统计学意义(P＜0.05).②孕期SLE活动的主要临床表现为:活动性狼疮肾炎(11例)、皮疹(10例)和关节炎(7例);主要并发症为各类感染(11例).③母儿结局:早产、胎儿生长受限( FGR)和胎儿丢失的发生率在活动组分别为42％、47％和26％,在稳定组分别为7％、15％和0,活动组较稳定组明显升高,差异有统计学意义(P＜0.05);子痫前期、胎儿窘迫和新生儿窒息的发生率在活动组分别为16％、16％和5％,在稳定组分别为7％、19％和0,2组相比差异无统计学意义(P＞0.05).11例活动性狼疮肾炎患者的早产和FGR的发生率分别为55％和64％,较无活动性狼疮肾炎者的11％和17％明显升高,差异有统计学意义(P＜0.05).⑤Logistic回归分析显示肾损害、低补体水平、抗磷脂抗体(aPL)阳性和血清尿素氮水平分别是早产、FGR、胎儿丢失和胎儿窘迫的独立危险因素(P＜0.05).结论 ①孕期SLE活动可明显增加早产、FGR和胎儿丢失的发生率;活动性狼疮肾炎可明显增加早产和FGR的发生率;②肾损害、低补体水平、aPL阳性和血清尿素氮水平与不良胎儿结局密切相关.     

妊娠期高血压不同严重程度患者分娩结局分析

目的分析妊娠期高血压病不同严重程度对分娩结局的影响。方法选取2016-02~2017-01诊治为妊娠期高血压病患者150例临床资料行回顾性分析,根据患者病情严重程度分为妊娠期高血压(轻度组)71例、轻度子痫前期(中度组)41例、重度子痫前期(重度组)38例,比较三组不良妊娠结局发生率。结果三组产妇年龄比较差异无统计学意义(P0.05);轻度组、中度组、重度组孕周和新生儿体重依次下降(P0.05),宫内窘迫、新生儿窒息、宫内生长受限发生率依次升高(P0.05),胎盘早剥、产后出血发生率依次升高。轻度组心力衰竭发生率显著低于重度组(P0.05)。结论妊娠期高血压病患者随着病情加重,胎儿、新生儿、产妇不良妊娠结局发生率逐渐升高。     

系统性红斑狼疮患者合并妊娠的临床研究

目的 探讨系统性红斑狼疮(SLE)患者妊娠的安全性、妊娠结局及对子代的影响.方法 回顾性分析1999年6月至2009年10月我院收治的SLE合并妊娠的患者的妊娠情况,比较选择性妊娠和非选择性妊娠组患者的SLE疾病活动情况、产科并发症情况、胎儿情况.并对SLE患者的子代进行随访.统计学处理采用x2检验和t检验.结果 SLE合并妊娠的患者共62例,选择性妊娠组43例,非选择性妊娠组19例;选择性妊娠组中10例(23%)患者在妊娠过程中出现疾病活动,8例(19%)流产,35例(81%)活胎分娩,其中低体质量儿7例,早产7例;非选择性妊娠组中16例(84%)出现疾病活动,13例(68%)流产,6例(32%)活胎分娩,均为低体质量儿,4例早产,3例合并胎儿生长受限.选择性妊娠组的妊娠过程中疾病活动率、流产率均显著低于非选择性妊娠组(P＜0.05).22例子代随访未发现SLE患儿.结论 选择性妊娠组与非选择性妊娠组患者均面临妊娠过程中SLE疾病活动及妊娠结局不良的风险,但是选择性妊娠组患者妊娠期间疾病稳定状况、母婴的预后均优于非选择性妊娠组.     

系统性红斑狼疮不良妊娠结局相关因素

目的 探讨系统性红斑狼疮(systemic lupus erythematosus, SLE)患者不良妊娠结局的相关因素。方法 对83例SLE患者85次妊娠事件的临床资料进行回顾性分析,采用Logistic回归模型分析不良妊娠结局的相关因素。结果 病情活动的SLE患者发生妊娠丢失(60%)、早产(30%)、子痫前期(43%)的风险更高(P<0.05)。SLE患者胎儿不良妊娠(adverse pregnancy outcomes, APO)和妊娠丢失组出现孕中发病、病情活动、白细胞下降、低补体、抗dsDNA阳性及泼尼松用量≥20 mg/d的比例升高。且接受临床干预的具有不良妊娠史(OR=5.837,95%CI:1.799～18.911,P=0.003)的SLE患者再次妊娠时,出现胎儿AP0的风险降低,其中皮疹(OR=0.047,95%CI:0.005～0.453,P=0.008)、抗SSA阳性(OR=0.265,95%CI:0.084～0.838,P=0.024)、泼尼松用量≥20 mg/d(OR=0.062,95%CI:0.010～0.391,P=0.003)是SLE胎儿APO相...     

系统性红斑狼疮合并妊娠71例的前瞻性研究和长期随访

目的：了解系统性红斑狼疮（SLE）患者妊娠的母婴风险因素。方法：前瞻性地观察1988－1999年间仁济医院SLE患者妊娠结果，将患者分为病控制1年经以上妊娠组（A组），妊娠前1年内有病情活动组（B组）和妊娠期首发病例组（C组），分别观察妊娠期及产后0．5年内母婴情况并长期随访。结果：71例患者中A组患者49例，B组患者13例，C组患者9例，1例患者因严重狼疮活动而终止妊娠，另1例患者产下双胎，出生活婴71名，无新生儿狼疮，无母婴死亡，妊娠期SLE活动比例A组9例（18．4％）显著低于B组10例（76．9％）和C组9例（100％（P＜0．01），A组妊娠期新发肾炎显著少于B、C组（P＜0．05），产后0．5年肾炎活动显著少于B组（P＜0．05），A组出生早产儿和低体重儿显著少于B组（P＜0．05），A组患者中既往有无SLE内脏累及者之间比较，妊娠期SLE活动和胎儿异常的比例差异均无显著性（P＞0．05），结论：SLE患者病情控制1年以上妊娠，母婴安全度显著增高，既往有内脏累及不构成特别的风险，妊娠前1年内有SLE活动者母婴风险显著增大。     

系统性红斑狼疮合并妊娠49例分析

目的 探讨系统性红斑狼疮(SLE)患者的妊娠时机及其对母婴的影响.方法 对1992年12月至2012年2月在我院住院的SLE合并妊娠患者的临床资料进行回顾性分析.率的比较采用x2检验.结果 49例SLE患者共妊娠52次.按照选择性妊娠与非选择性妊娠分组,选择性妊娠组27例,活产24例(89％),早产3例(12％),低出生体质量儿4例(17％),妊娠期疾病出现活动5例(18％);非选择性妊娠组25例,活产12例(48％),早产6例(50％),低出生体质量儿6例(50％),妊娠期疾病出现活动20例(80％).选择性妊娠组活产率明显高于非选择性妊娠组(P＜0.01),早产率明显低于非选择性妊娠组(P＜0.05),妊娠期间疾病活动明显少于非选择性妊娠组(P＜0.01).结论 SLE患者选择适当的妊娠时机,妊娠期间加强风湿免疫科及产科的监护,可以提高活产率,降低妊娠期间病情活动和早产率.     

产前HbA1c水平对妊娠期糖尿病孕产妇妊娠结局影响

目的研究产前糖化血红蛋白(HbA1c)水平对妊娠期糖尿病孕产妇妊娠结局影响。方法 2016年1月—2018年12月间选择妊娠期糖尿病孕产妇(妊糖组)和正常孕产妇(对照组)为研究对象,年龄、孕次、产次和孕周方面均具有可比性,比较两组孕产妇妊娠结局的差异,分析产前HbA1c与妊娠结局相关性。结果妊糖组妊娠期糖尿病孕产妇围产期产后出血、子痫前期、羊水异常、胎膜早破及早产发生率均显著高于对照组正常孕产妇(P0.05)。妊糖组妊娠期糖尿病孕产妇产新生儿体重异常、新生儿黄疸、胎儿窘迫及死胎发生率均显著高于对照组正常孕产妇产新生儿(P0.05)。产前HbA1c与产后出血、子痫前期、羊水异常、胎膜早破、早产、新生儿体重异常、新生儿黄疸、胎儿窘迫及死胎均呈正相关(均P0.05),产前Hb A1c越高,围产期产后出血、子痫前期、羊水异常、胎膜早破、早产、新生儿体重异常、新生儿黄疸、胎儿窘迫及死胎发生率越高。结论产前HbA1c水平对妊娠期糖尿病孕产妇妊娠结局具有重要影响,与围产期并发症密切相关,临床上应积极干预。     

抗凝药物对妊娠期高血压疾病母胎结局的影响

目的探讨抗凝药物对妊娠期高血压疾病(早发型子痫前期、慢性高血压并发子痫前期)母胎结局的影响。方法将2014-01~2016-12在广西医科大学第一附属医院产科住院引产或分娩的诊断为早发型子痫前期或慢性高血压并发子痫前期的60例孕妇作为研究对象,按照随机数字表法分为对照组和观察组各30例,对照组孕期给予常规治疗,观察组孕期(孕12~14周开始)给予抗凝药物治疗(阿司匹林片,口服,50~75 mg/d,14~28 d,和那曲肝素钙注射液4 100 U/d,皮下注射,7~10 d)。比较两组母胎结局。结果两组孕妇治疗前及治疗后1个月的凝血功能比较,差异均无统计学意义(P0.05)。观察组在改善脐血流异常、胎儿生长受限,减少胎儿窘迫、新生儿窒息发生优于对照组(P0.05);不增加孕妇妊娠期高血压并发症如HELLP综合征、产后出血、胎盘早剥、剖宫产率、早产率、胎儿畸形、围产儿死亡等风险(P0.05);观察组有子痫前期病史的6例孕妇此次妊娠与上次妊娠的发现血压高孕周及终止妊娠孕周对比,发现血压高孕周及终止妊娠孕周明显延长,差异有统计学意义(P0.05)。结论 (1)孕早期(孕12周)开始使用抗凝治疗至28周,对妊娠期高血压疾病(尤其是早发型子痫前期和慢性高血压并发子痫前期)可延长妊娠孕周,改善母胎结局。(2)有子痫前期病史的孕妇在孕早期(孕12周)口服阿斯匹林片50~75 mg/d,可延迟子痫前期终止妊娠孕周。(3)孕期口服阿斯匹林片在安全剂量(50~100 mg)下使用不增加产后出血、胎盘早剥等风险,无致畸作用,安全有效。     

探讨妊娠期糖尿病合并慢性高血压孕妇的胰岛素抵抗水平及其对妊娠结局的影响

目的 评定妊娠期糖尿病合并慢性高血压孕妇的胰岛素抵抗水平以及对妊娠结局的影响。方法 选取2020年5月—2022年5月福鼎市医院收治的妊娠期糖尿病患者200例,依据其是否合并慢性高血压分组,合并慢性高血压者100例为高血压组,未合并慢性高血压者100例为无高血压组。比较两组血糖、血压、胰岛素抵抗程度、孕前体质指数及胎次,以及早产、巨大儿、子痫前期、死胎、体质量过低的不良妊娠结局,Logistic回归分析胰岛素抵抗与不良妊娠结局的关系。结果 两组年龄、胎次对比,差异无统计学意义(P>0.05);高血压组胰岛素抵抗指数(3.51±1.17)、空腹血糖水平(5.76±0.58)mmol/L、孕前体质指数(26.51±4.25)kg/m²、收缩压(135.46±5.44)mmHg、舒张压(95.43±5.97)mmHg均高于无高血压组,胰岛素水平(11.94±3.01)μU/mL低于无高血压者,差异有统计学意义(P<0.05)。结论 妊娠期糖尿病合高血压者存在一定的胰岛素抵抗情况,增加子痫前期的发生率。     

Pregnancy outcome in 396 pregnancies in patients with SLE in Saudi Arabia

The aim of this study was to examine the pregnancy outcomes in patients with systemic lupus erythematosus (SLE) and the effect of SLE flare and treatment on pregnancy outcomes. We performed a retrospective evaluation of all pregnancies occurring in patients with SLE during the 27-year period from 1980 to 2006. Of the 319 women with SLE planning pregnancy after SLE onset, 176 (55.2%) conceived resulting in 396 pregnancies. Live births were significantly lower in proportion (70.2% vs. 85.7%) and more likely to end in fetal deaths (29.7% vs. 14.2%) and preterm births (26.7% vs. 5.8 %) in pregnancies occurring after SLE onset than in pregnancies occurring before SLE onset (p < 0.0001). With respect to different disease manifestations, we found that fetal loss was significantly higher in patients with antiphospholipid (aPL) antibodies than without (p < 0.001). Preterm deliveries were significantly more frequent in patients with lupus nephritis, anti-Ro/SSA antibodies, hypertension, history of intravenous cyclophosphamide treatment and aPL than those without these features (p < 0.05). Neonates with intrauterine growth retardation (IUGR) neonates were more common in hypertensive and Raynaud's-positive pregnancies (p < 0.05). SLE flares occurred in 30.8% pregnancies. There was increased risk of fetal loss, preterm births and IUGR in pregnancies with SLE exacerbations than without (p < 0.05). Prednisolone was found to improve the rate of live births, although it was also a predictor of prematurity. The predictors of pregnancy loss were lupus nephritis (odds ratio (OR) 7.3), aPL (OR 3.9), and SLE flares in pregnancy (OR 1.9). There was higher risk of preterm deliveries in patients with lupus nephritis (OR 18.9), anti-Ro antibodies (OR 13.9), hypertension (OR 15.7) and SLE flares (OR 2.5). IUGR was found to be associated with hypertension (OR 37.7), Raynaud's (OR 12.3), and SLE flares (OR 4.2). In conclusion, pregnancies in SLE patients with active lupus nephritis, anti-Ro/SSA antibodies, aPL, hypertension, Raynaud's phenomenon, active disease at conception and SLE exacerbations are at a higher risk of adverse pregnancy outcomes. It is important to carefully plan pregnancy, and experienced rheumatologists and obstetricians should monitor SLE patients in pregnancy and postpartum.     

Maternal and fetal outcomes of 72 pregnancies in Argentine patients with systemic lupus erythematosus (SLE)

The purpose of the following study was to analyze maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE) and the influence of SLE exacerbations on those pregnancies. Seventy-two pregnancies in 61 SLE patients treated between January 1986 and February 2004 in Hospital de Clínicas “José de San Martin” were reviewed retrospectively. Patient age was 28.1 ± 6.2 years (mean±standard deviation [SD]). Mean SLE duration was 4.5 ± 3.2 years (range 6 months–10 years). No patient acquired the disorder during gestation. Four (5.5%) patients had signs of active disease at the beginning of her pregnancy. Sixteen patients, accounting for 20 pregnancies, had a history of lupus nephritis. Nine patients met secondary antiphospholipid syndrome criteria and had 13 pregnancies. There were 14 exacerbations of the disease during pregnancy (19.4%), with most flares being mild. The most common obstetric complications were gestational hypertension in 15 pregnancies (20.8%) and preeclampsia in 8 pregnancies (11%). Forty-six percent of pregnancies ended in preterm deliveries. There were 62 live births (1 twin birth; 85%), 6 stillbirths (8%), and 5 spontaneous abortions (7%). Thirty-nine percent of newborns had low birth weight. Adequate pregnancy follow-up and delivery care by an interdisciplinary team in Argentine SLE patients with no pre-gestational preparation resulted in maternal and fetal outcomes similar to those seen in world reference centers.     

Could women with systemic lupus erythematosus (SLE) have successful pregnancy outcomes? Prospective observational study

Aim of the workThe aim of this study was to determine the frequencies and predictors of maternal and fetal pregnancy outcomes in women with systemic lupus erythematosus (SLE).Patients and methodsData of 37 pregnancies of 34 patients with systemic lupus erythematosus were collected prospectively from patients at Rheumatology and Rehabilitation department of Cairo University Hospitals from 2007 to 2009. Univariate analysis and logistic regression analysis were used.ResultsThere were five spontaneous miscarriages, and 32 pregnancies resulting in live births. There were 20 full term babies and 12 preterm babies. Eight fetuses were born with intrauterine growth retardation (IUGR) and seven babies were born with low birth weight (LBW). Six babies were incubated at NICU (premature) with four neonatal deaths. Among 37 pregnancies, 32 women (86.5%) were in clinical remission before pregnancy; only five patients (13.5%) were active. There were 21/32 episodes of SLE flare up (65.6%) during pregnancy and eight postpartum flare up (21.6%). Eight women (21.6%) developed preeclampsia during pregnancy. Planned pregnancy and SLEDAI at the beginning of pregnancy were significantly associated with fetal loss at univariate analysis. However, there were no significant predictors of fetal loss at binary logistic regression analysis. There was no maternal mortality reported. Renal lupus disease was found to be a predictor of pre-eclampsia occurrence in univariate analysis (P = 0.04).ConclusionIn general, pregnancies can be successful in most women with SLE with a favorable fetal outcome. SLE tends to flare during pregnancy. Flares are maximal during the second trimester.     

Clinical and serological risk factors of systemic lupus erythematosus outcomes during pregnancy

IntroductionSLE is an important risk factor for mother and fetus during pregnancy.Aim of the workTo identify clinical and serological risk factors that may cause poor maternal and fetal outcomes in pregnant systemic lupus erythematosus (SLE) patients.Patients and methodsForty selected SLE pregnant women (group A) versus 35 non-pregnant SLE patients (group B). SLE disease activity index (SLEDAI) and flares were evaluated for both groups. Laboratory investigations included double stranded DNA, anticardiolipin antibodies (aCL), and complements (C3 & C4). SLE pregnant patients were followed up in the second and third trimesters by ultrasonography and fetal Doppler were done to assess fetal outcome. Risk factors for poor maternal and fetal outcome were recorded.ResultsSLEDAI was increased in both groups more in group A. Lupus flares were increased during pregnancy as it occurred in (62.5%) of group A compared to (37.14%) in group B where severe flares were more frequent in group A. Gestational hypertension and active SLEDAI were found statistically significant for poor maternal outcome. Fetal outcome included full term 37.5%, prematurity 25%, intra-uterine growth retardation (IUGR) 22.5%, stillbirth 12.5%, abortion 7.5% and congenital heart block (CHB) 2.5%. Factors significantly associated with poor fetal outcome were severe flares and active renal disease where fetal loss significantly associated with aCL antibodies. Full term was more common in patients with no flares.ConclusionThese data demonstrate that pregnancy in SLE patients should be considered as a high-risk pregnancy and conception should be planned during a quiescent period. Close monitoring for optimal disease control of flares, lupus nephritis, gestational hypertension and aCL antibodies is recommended.     

Hot topics in lupus pregnancy

Systemic lupus erythematosus (SLE) typically affects women in their childbearing age, who have the same fertility rates as the healthy population. The effect of pregnancy on the disease and the effect of SLE on pregnancy and the fetus are highly important issues for the attending physician. Whether lupus flares are more frequent during pregnancy remains controversial. Among the possible effects of SLE on pregnancy are a greater number of abortions, fetal loss, pre-term deliveries and perinatal mortality. The newborn may be affected by the onset of neonatal lupus erythematosus (neonatal LE), either as a skin or blood disease, or by the presence of congenital heart block. The frequent association between SLE and antiphospholipid syndrome represents another risk situation for the mother and the product of conception. Multiples drugs used in SLE patients should be evaluated. Those with teratogenic potential should be withdrawn before pregnancy, and when necessary, appropriate medications should be indicated to treat the mother without compromising the safety of the baby. In conclusion, pregnancies in lupus patients represent a challenge for the physician and must be closely followed up and treated if necessary, during all trimesters and in the puerperium period, to improve outcome.     

Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy

Previous reports suggest that renal involvement before pregnancy or active renal disease during pregnancy may be associated with poor fetal and maternal outcomes in systemic lupus erythematosus (SLE) women. We report our experience of fetal and maternal complications in pregnant lupus women with and without previous lupus nephritis. We analyzed the clinical records of pregnant SLE patients attended in a tertiary reference center during a 5-year period. Patients were allocated into two groups according to the presence or absence of previous lupus nephritis. Women were evaluated monthly during pregnancy and at least 1 month postpartum. Maternal and fetal outcomes of pregnancy were abstracted. We included 95 pregnancies in 92 patients. Compared with pregnant women without lupus nephritis (n = 60), pregnancies with previous lupus nephritis (n = 35) were associated with a higher risk of maternal complications (88.5% vs. 43.3%, p = 0.00001), higher rate of lupus flares (54.2% vs. 25%, p = 0.004), and renal flares (45.7% vs. 6.6%, p = 0.00001), but most of which in most instances were reversible. On the other hand, fetal outcome was similar in both groups. Multivariate analysis showed that previous lupus nephritis and active lupus at conception were predictors of adverse maternal outcome. Pregnancies in women with previous lupus nephritis had a higher rate of maternal complications in comparison with those without. However, fetal prognosis was similar in both groups.     

Outcomes of planned pregnancy in patients with systemic lupus erythematosus and their neonates

Aim of the workTo assess the outcome of planned pregnancies in patients with systemic lupus erythematosus (SLE). Patients and methods: The study was conducted on 32 patients. The medical management included pre-pregnancy planning at the quiescent phase of the disease and after at least six months of clinical remission. The patients had a monthly visit during pregnancy and three months post-delivery. Disease flare was characterized by the recurrence of symptoms and signs in different organs, as well as the need for an increase in medication dose. Results: There were 36 planned pregnancies in 32 patients, of which 15 and 17 cases were primiparous and multiparous, respectively. The SLE flares were observed in 36.1% of the cases, 8.3% of which developed postpartum; moreover, they were moderate in severity and mostly involved the kidneys and joints. Pregnancy outcomes included18 (50%) cases ended in term labor; 13 (36.1%) pregnancies had preterm labor, and 5 (13.8%) pregnancies terminated with abortions. Furthermore, obstetric complications included 2(6.5%) patients with premature rupture of membranes, 5(15.6%) fetuses with intrauterine growth retardation, and 2(6.4%) mothers with preeclampsia. 10(27.7%) pregnancies occurred in patients with lupus nephritis. Cesarean section was performed on 24(77.4%) patients, and low birth weight was observed in 7(21.8%) infants. None of the infants had neonatal lupus, congenital deformities or infection. Conclusion: Pre-pregnancy planning in patients with SLE can considerably improve pregnancy outcomes. Neonatal lupus, congenital anomalies or infection were not present. SLE patients intending to become pregnant should be provided with close medical supervision for a safe maternal and fetal outcome.