Aida Kalok, Rizna Abdul Cader, Ima Indirayani, Abdul Kadir Abdul Karim, Shamsul Azhar Shah, Nor Azlin Mohamed Ismail, Mohd Hashim Omar, Mohamad Nasir Shafiee
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory condition with multi-organ involvement predominantly affecting young women. There are very limited studies in pregnancy in Asian SLE patients and therefore we embarked on this study to identify pregnancy outcomes of Malaysian women with SLE. Materials and methods: We performed a retrospective study of pregnancy outcomes in SLE patients in our institution from January 2007 to December 2014. A total of 71 pregnancies from 44 women were analysed. Results: The mean age of our cohort was 30.5 ± 3.9 years. The rate of active disease at conception, antiphospholipid syndrome and lupus nephritis were 22.5%, 32.4% and 57.7% respectively. SLE flare occurred in 33 out of 71 pregnancies whereas 19 pregnancies were complicated with preeclampsia. The livebirth rate for our cohort was 78.9%, whilst preterm delivery was 42.9%. On univariate analysis, active disease and flare in pregnancy were both strongly associated with foetal loss and preterm delivery. Lupus nephritis (p = 0.011), SLE flare (p = 0.008) and antiphospholipid syndrome (p = 0.032) significantly increased the risk of preeclampsia. Aspirin and hydroxychloroquine were protective against foetal loss [odds ratio (OR) 0.12] and preeclampsia (OR 0.25), respectively. On multivariate analysis, active disease was a predictor of SLE flare (p = 0.002) and foetal loss (p = 0.018) and SLE flare was the main predictor of preterm delivery (p = 0.006). Conclusions: Pregnancies in women with SLE should be planned and aspirin and HCQ use were beneficial in reducing adverse pregnancy outcomes. © 2019 Walter de Gruyter GmbH. All rights reserved.
Faculty of Medicine, Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Faculty of Medicine, Department of Obstetrics and Gynecology, Syiah Kuala University, Banda Aceh, Indonesia; Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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