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Lupus Nephritis

Pregnant women with lupus nephritis should be monitored closely

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Patients with lupus nephritis (LN) who are pregnant experience more complications, but the disease does not lead to worse fetal outcomes, according to a study.

In this retrospective study, 121 pregnancies in 79 patients, including 69 with LN and 52 with systemic lupus erythematosus (SLE), were evaluated. Of the patients with LN, 47.5% had Class IV LN.

Patients with LN more frequently had antiphospholipid syndrome (APS) and antiphospholipid antibodies (AAF) as well as higher basal SLEDAI. More immunosuppressive therapy and increased steroid dose treatment were reported in patients with 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. No patients developed end-stage renal failure.

Preeclampsia occurred in 18.8% of patients with LN and 6.3% of patients without LN. Overall, 68.5% of patients in the LN and 31.5% in the patients without LN needed a cesarean section. There was 1 maternal death.

No differences in fetal outcomes were found between the groups.

Reference
Otaduy C, Gobbi CA, Álvarez A, et al. Is lupus nephritis a prognosis factor for pregnancy? Maternal and foetal outcomes. Reumatol Clin. 2021:S1699-258X(21)00091-7. DOI: 10.1016/j.reuma.2021.02.011.

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