Open Access Rheumatology: Research and Reviews (Feb 2024)

Adverse Impact of Systemic Lupus Erythematosus on Pregnancy Outcomes: A Saudi Arabia Retrospective Multi-Center Study

  • Al Rayes H,
  • AlOudah N,
  • Alsolaimani R,
  • Alharthi A,
  • Attar M,
  • Daghasi H,
  • Albeity A,
  • Afifi AM,
  • AlQahtani A,
  • Alkaff A,
  • Alkhamesi SM,
  • Elnady B

Journal volume & issue
Vol. Volume 16
pp. 31 – 41

Abstract

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Hanan Al Rayes,1 Norah AlOudah,1 Roaa Alsolaimani,2,3 Abdulrahman Alharthi,4 Mohammed Attar,4 Hassan Daghasi,4 Abdurahman Albeity,2 Afnan M Afifi,2 Abdulelah AlQahtani,1 Alya Alkaff,5 Sultan M Alkhamesi,3 Basant Elnady4,6 1Department of Rheumatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 2Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 3Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Rheumatology, Al Hada Armed Forces Hospital, Taif, Saudi Arabia; 5Obstetrics and Gynecology Department, King Faisal Specialist Hospital, and Research Center, Jeddah, Saudi Arabia; 6Rheumatology and Rehabilitation Department, Faculty of Medicine, Benha University, Benha, EgyptCorrespondence: Basant Elnady, Tel +966562387723, Email [email protected]: The current study aimed to determine the pregnancy outcomes complications in patients with SLE and its association with clinical, laboratory variables, disease activity, and medication use in the Saudi population, as well as pregnancy effect on disease activity.Methods: A multicenter study included pregnant female patients with Systemic Lupus Erythematosus (SLE) from three tertiary centers in Saudi Arabia. The demographics, clinical, and laboratory variables, SLE disease activity index (SLEDAI), medication before, during, and after pregnancy, planned pregnancy, pregnancy-related outcomes, and complications in comparison to age-matched healthy female controls were noted.Results: A total of 66 pregnant patients with SLE and 93 healthy age-matched pregnant controls were included in the study. A total of 77.3% had SLEDAI-2K ≤ 4 before conception, and 84.85% of pregnancies were planned. Age of conception, cesarean section, miscarriage, and low birth weight were statistically significant (p 4 and active lupus nephritis during pregnancy were statistically associated with adverse outcomes (p 4 was an independent risk at least 4.87 times higher association with adverse pregnancy outcomes. (p < 0.05).Conclusion: SLE is intricately connected with unfavorable pregnancy outcomes. The preconception of high disease activity stands as a pivotal risk factor for adverse outcomes. Despite the disease remission and meticulous planning, SLE patients frequently grapple with disease exacerbations during pregnancy, culminating in unexpected and unfavorable pregnancy-related outcomes. This underscores the intricate and multifaceted nature of managing SLE during gestation.Keywords: systemic lupus erythematosus, pregnancy, disease activity

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