Accessible Requires Authentication Published by De Gruyter September 25, 2019

Pregnancy outcomes in systemic lupus erythematosus (SLE) women

Aida Kalok, Rizna Abdul Cader, Ima Indirayani, Abdul Kadir Abdul Karim, Shamsul Azhar Shah, Nor Azlin Mohamed Ismail, Mohd Hashim Omar and Mohamad Nasir Shafiee



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.


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).


Pregnancies in women with SLE should be planned and aspirin and HCQ use were beneficial in reducing adverse pregnancy outcomes.

Author statement

  1. Research funding: None declared.

  2. Conflict of interest: Authors declare no conflict of interest.

  3. Ethical approval: Ethics approval was obtained from the University Research and Ethics Board (FF-2013-465).

  4. Informed consent: This is a retrospective study which involved analysis of patients data, who are being kept anonymous. Informed consent was not required.


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Received: 2019-03-04
Accepted: 2019-07-11
Published Online: 2019-09-25

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