International Journal of Medical Sciences

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23 October 2017

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Int J Med Sci 2011; 8(7):577-583. doi:10.7150/ijms.8.577

Research Paper

Pregnancy Outcomes and Appropriate Timing of Pregnancy in 183 pregnancies in Korean Patients with SLE

Hyun Sun Ko1, Hyun Young Ahn1, Dong Gyu Jang1, Sae-Kyung Choi1, Yong-Gyu Park2, In Yang Park1, Guisera Lee1, Sung-Hwan Park3, Jong Chul Shin1 ✉

1. Department of Obstetrics and Gynecology, College of Medicine, Catholic University, Seoul, Korea;
2. Department of Biostatistics, College of Medicine, Catholic University of Korea; 3Division of Rheumatology,
3. Department of Internal Medicine, College of Medicine, Catholic University of Korea

Abstract

This study was undertaken to investigate the pregnancy outcomes in patients with systemic lupus erythematosus (SLE) and the appropriate timing of pregnancy. We performed a retrospective evaluation of 183 pregnancies with SLE at Catholic University Medical Center during the 13-year period from 1998 to 2010. Pregnancy outcomes were compared according to SLE characteristics. The predictive value of the different cut-off points of the stable period before conception on adverse pregnancy outcomes was calculated by ROC (Receiver operating characteristics) curve analysis. In multivariate analysis, the presence of antiphospholipid antibodies (aPLs) increased the risk of pregnancy loss (p<0.0001) and premature birth (p=0.0040). Active disease at conception increased the risk of premature birth (p< 0.0001) and complications (IUGR, PIH, or both) (p= 0.0078). The other predictor of complications was found to be lupus flare (p=0.0252). At a cut-off level of stable period of 4 months before conception, sensitivity and specificity were 70.8% and 53.2%, 71.4% and 61.5%, and 63.6 % and 59.8 %, respectively on reducing pregnancy loss, premature birth, and complications. Pregnancies with aPLs, active disease at conception and SLE flares are at a higher risk of adverse outcomes. It is essential that disease activity remains stable at least 4 months before conception, for favorable pregnancy outcomes.

Keywords: Systemic lupus erythematosus, Pregnancy outcomes, Disease activity

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Ko HS, Ahn HY, Jang DG, Choi SK, Park YG, Park IY, Lee G, Park SH, Shin JC. Pregnancy Outcomes and Appropriate Timing of Pregnancy in 183 pregnancies in Korean Patients with SLE. Int J Med Sci 2011; 8(7):577-583. doi:10.7150/ijms.8.577. Available from http://www.medsci.org/v08p0577.htm