Abstract:
Systemic Lupus Erythematosus (SLE) influences
pregnancy outcomes. Objectives: To compare the pregnancy out comes and
contraceptive practices in SLE with rheumatoid arthritis (RA) and women with no
chronic illness (WNCI). Methods: Patients with SLE and history of pregnancies
were identified from University lupus clinic. Age matched women with history of
pregnancy and RA were obtained from rheumatology clinic and WNCI from a
surgical clinic. Comparisons between live birth rates (LBR), pregnancy losses,
contraceptive use and planned pregnancies in the three groups were done using chi
square test. Results: In 78 patients with SLE, 59 pregnancies occurred before and
20 after diagnosis. In 32 patients with RA, 72 pregnancies occurred before and 8
occurred after diagnosis. The mean age at diagnosis was higher (p< 0.01) in RA
(35years) than in SLE (26 years) using student t test. LBR after diagnosis was
significantly lower (p<0.01) in SLE (9/20, 45%) compared to RA (6/8, 75%) and
WNCI (77/85,91%). Adverse pregnancy outcomes (fetal loss, pre-maturity, low
birth weight) and assisted deliveries Were more (p<0.001)in SLE than in WNCI.
Unplanned pregnancies were more (p<0.01)in SLE (80%) Than in RA (25%) and
in WNCI (9.4%). Contraceptive usage was lower in patients with SLE (25.6%)
compared to WNCI (56.4%). Disease exacerbations occurred in 20% in SLE
during pregnancy and no babies developed neonatal lupus.
Conclusions:Unplanned pregnancies and adverse pregnancy outcomes need to be
addressed more in SLE than in RA or in WNCI.
