Maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus: A study from a Latin American developing country

Abstract

Introduction

Systemic lupus erythematosus (SLE) primarily affects women of reproductive age. In pregnant women, frequent antepartum and intrapartum monitoring is required to improve obstetric outcomes and reduce the risk of flares. This study describes the characteristics of pregnant women with SLE and their obstetric and disease outcomes.

Methods

Retrospective descriptive cohort in a hospital in Bogotá, Colombia, from 1/January/2012 to 29/February/2024. The research was approved by the Ethics Committee. Descriptive statistics and univariate analysis by Fisher and Mann-Whitney U test were used.

Results

We analyzed 29 pregnancies of 28 women with a median age of 28 years, high educational and socioeconomic level, belonging to the social security system, and residing in Bogotá. Most of them had been diagnosed with SLE before pregnancy (median disease duration of 60 months). Twenty percent had poly-autoimmunity. Overall disease activity was mild to moderate. Obstetric outcomes (e.g. preterm delivery) were associated with a moderate to severe SLEPDAI (Systemic Lupus Erythematosus Pregnancy Disease Activity Index) score in the second and third trimester (83%, p = .04), shorter disease duration (24 vs 96 months, p = .027) and proteinuria >1 g (40.91%, p = .03).

Conclusions

This study associates preterm delivery with factors such as proteinuria >1 g, shorter disease duration, and a moderate to severe score in the second trimester of pregnancy. A higher level of evidence is required to establish these associations with the causality of adverse outcomes in the Latin American population.