Outcome of Pregnancy in Patients with Systemic Lupus Erythematosus
Background: Systemic lupus erythematosus (SLE) is
an autoimmune disease which involves many different
organ systems and immunological abnormalities. SLE
mainly affects females in their reproductive age. This
study aimed to describe the fetal outcome, neonatal
complications, maternal outcome, and obstetrics
complication in patients diagnosed with SLE, in order
to help the physicians to reduce the fetal loss, improve
maternal morbidity, and reduce neonatal or maternal
deaths.
Method: This research was conducted using descriptive
quantitative design. Data were obtained from direct
interview noted in a report form and medical records.
Subjects were SLE patients who came to Rheumatology
Outpatient clinic, Dr. Hasan Sadikin General Hospital,
Bandung from September 2016 to November 2016; and
fulfilled the inclusion and exclusion criteria. The minimal
required sample was 96 subjects.
Results: Due to time limitation, only 53 pregnancies
from 40 females were managed to be recorded. The
median age when being diagnosis of the subjects was
24 (14 – 41) years old. The fetal outcomes showed
64.2% live births, 18.9% spontaneous abortions,
9.4% intrauterine death, 1.8% intrauterine growth
retardation, and 9.1% neonatal deaths. Neonatal
complications included premature delivery, low birth
weight, and growth retardation. Maternal complications
during pregnancy included rash, pregnancy-induced
hypertension, arthritis, anemia, and thrombocytopenia.
Furthermore, obstetric complications included 13.2%
pre-eclampsia, 13.2% placenta previa, and 1.8% stroke.
There were 2 cases (3.8%) of maternal death happened
during the delivery.
Conclusion: The most frequent maternal complications
during pregnancy were arthritis and rash. Pre-eclampsia
and placenta previa were the most frequent obstetric
complications which experienced by the pregnant SLE
patients. Exclude the live births, the most frequent fetal
outcome was spontaneous abortion. The most frequent
neonatal complications were preterm delivery and low
birth weight.
Keywords: pregnancy, systemic lupus erythematosus,
fetal outcomes, maternal outcomes