Samantha C Do1, Maurice L Druzin. 1. Stanford University, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Stanford, California, USA.
Abstract
PURPOSE OF REVIEW: The aim of this study was to describe risks of systemic lupus erythematosus (SLE) in pregnancy and the importance of preconception counselling, medication optimization and close surveillance. RECENT FINDINGS: Advances in care for pregnant patients with SLE have led to improved obstetric outcomes, but maternal and foetal risks continue to be elevated. Conception during periods of disease quiescence and continuation of most medications decrease adverse pregnancy outcomes. Hydroxychloroquine (HCQ) appears protective against flares in pregnancy, neonatal congenital heart block and preterm birth. SUMMARY: SLE in pregnancy confers increased maternal and foetal risks, including disease flares, preeclampsia, preterm birth, foetal growth restriction, neonatal lupus erythematosus (NLE) and congenital heart block. Disease control on an effective medication regimen mitigates many of these risks, but pregnancy in women with SLE remains a high-risk condition requiring multidisciplinary care and an individualized approach to each patient.
PURPOSE OF REVIEW: The aim of this study was to describe risks of systemic lupus erythematosus (SLE) in pregnancy and the importance of preconception counselling, medication optimization and close surveillance. RECENT FINDINGS: Advances in care for pregnant patients with SLE have led to improved obstetric outcomes, but maternal and foetal risks continue to be elevated. Conception during periods of disease quiescence and continuation of most medications decrease adverse pregnancy outcomes. Hydroxychloroquine (HCQ) appears protective against flares in pregnancy, neonatal congenital heart block and preterm birth. SUMMARY:SLE in pregnancy confers increased maternal and foetal risks, including disease flares, preeclampsia, preterm birth, foetal growth restriction, neonatal lupus erythematosus (NLE) and congenital heart block. Disease control on an effective medication regimen mitigates many of these risks, but pregnancy in women with SLE remains a high-risk condition requiring multidisciplinary care and an individualized approach to each patient.
Authors: Xiaoyuan Han; Mohammad S Ghaemi; Kazuo Ando; Laura S Peterson; Edward A Ganio; Amy S Tsai; Dyani K Gaudilliere; Ina A Stelzer; Jakob Einhaus; Basile Bertrand; Natalie Stanley; Anthony Culos; Athena Tanada; Julien Hedou; Eileen S Tsai; Ramin Fallahzadeh; Ronald J Wong; Amy E Judy; Virginia D Winn; Maurice L Druzin; Yair J Blumenfeld; Mark A Hlatky; Cecele C Quaintance; Ronald S Gibbs; Brendan Carvalho; Gary M Shaw; David K Stevenson; Martin S Angst; Nima Aghaeepour; Brice Gaudilliere Journal: Front Immunol Date: 2019-06-11 Impact factor: 7.561