Clinical study of 80 cases of pregnant women with systemic lupus erythematosus

Objective:To explore the impact of lupus flares on maternal and fetal outcomes in pregnant women with systemic lupus erythematosus(SLE)，and to determine the proper pregnancy time and curative therapy for them． Methods:Eighty-six pregnancies of 80 pregnant women with SLE were divided into the active group and stable group according to the disease activity index，the positive antiphospholipid antibody(APL) group and negative antiphospholipid antibody group according to the findings of APL，the lupus nephritis(LN) group and non-LN group according to the kidney damage in the process of pregnancy，the glucocorticoid(GCs) group and GCs group according to whether immunosuppressant was employed in the process of treatment，and the hydroxychloroquine(HCQ) group and non-HCQ group． The detailed clinical data and laboratory data of the SLE patients were recorded． Results:Three patients died due to pregnancy，with a mortality rate of 3． 75%． None of the death cases had received regular treatment and their diseases were all in high activity． Twenty-six fetuses died and 60 survived;the fetal mortality rate was 30． 2% and the survival rate 69． 8%． Poor pregnancy occurred in 66． 3% of the patients，with no fetal malformation． There were significant differences between the stable group and the active group in the rate of adverse pregnant outcomes(58． 8% vs 94． 4%，P 0． 01)． There were significant differences between the group with positive APL and the group with negative APL in the rate of adverse pregnant outcomes(61． 1% vs 92． 9%，P 0． 05)． There were no significant differences between the LN group and the non-LN group in the rate of adverse pregnant outcomes(62． 8% vs 8/8，P ＞0． 05)． There were significant differences between the group treated with GCs and immunosuppressive agents and the group only treated with GCs in the rate of adverse pregnant outcomes(38． 5% vs 95． 0%，P 0． 01)． There were no significant differences between the group treated with HCQ and the group without in the rate of adverse pregnant outcomes(58． 3% vs 68． 1%，P ＞0． 05)． Conclusions: The time of pregnancy，treatment before and during pregnancy，and positive APL might all influence the prognosis of the fetus of the women with SLE． Close monitoring may obtain relatively satisfactory fetal outcomes．