Lupus nephritis does not lead to a worse pregnancy

Lupus nephritis (LN) does not lead to worse pregnancy or fetal outcomes, although women with LN experienced more maternal complications, according to a study.

A retrospective study of all pregnant patients with systemic lupus erythematosus (n = 79; 121 pregnancies), including 69 patients with LN and 52 without LN, found that those with LN had more frequent presence of antiphospholipid syndrome (APS) and antiphospholipid antibodies (AAF) and received more immunosuppressive therapy and increased steroid dose treatment.

Nearly half (47.5%) of patients with LN had Class IV LN.

Lupus flares occurred in 25.8% of patients with LN and 10.9% of patients without LN. Renal flares were the most common in the LN group and no patients developed end-stage renal failure.

Preeclampsia occurred in 18.8% of patients with LN and 6.3% of patients without LN, and A cesarean section was required in 68.5% and 31.5% of patients, respectively. There was only 1 maternal death.

There were no differences in fetal outcomes.

The authors suggested that patients with LN should be monitored before and after conception.

Reference
Otaduy C, Gobbi CA, Álvarez A, et al. Is lupus nephritis a prognosis factor for pregnancy? Maternal and foetal outcomes. Reumatol Clin (Engl Ed). 2021 Sep 17:S2173-5743(21)00165-9. doi: 10.1016/j.reumae.2021.02.008. Epub ahead of print. PMID: 34538769.