328 l APRIL JOGC AVRIL 2013
In pregnancies in women with SLE, the risk for preterm birth
(< 37 weeks’ gestation) is estimated to be 33%.
In our study
31.6% of pregnancies were preterm, which is consistent
with other reports. In the Hopkins Lupus Pregnancy
Cohort, the rate of prematurity was almost twice as high
when the disease was active (66%) as when it was inactive
SLE, a history of ITP, higher maternal age, a rst
pregnancy, previous pregnancy loss, antenatal treatment with
corticosteroids, and use of low-dose ASA were associated
with preterm deliveries in our study. It is probable that ASA
was used in women with a poor pregnancy history; it is an
unexpected predictor for many adverse outcomes.
of corticosteroids has also been proposed as a risk factor for
preterm delivery and premature rupture of membranes for
the same reason.
The incidence of small for gestational age in pregnancies
in women with SLE (9.4%) is comparable to the dened
incidence in the general population of 10%.
rate of 35% was reported in the Hopkins Lupus Pregnancy
The rate of SGA among the pregnancies in our
cohort with a live birth was 17.3%. We found that SLE, ITP,
rst pregnancy, thromboembolism, and previous pregnancy
loss were associated with SGA infants.
In the current study, the rate of CHB in the SLE group
was 4.1%. CHB is associated with a mortality rate of
20% to 30% in the neonatal period.
In our cohort, one
baby with multiple congenital anomalies including CHB,
polymicrogyria, and arteriovenous malformation of the lung
expired during the rst week of life. Boros et al.
that hydrocephalus and macrocephaly are manifestations
of NLE and that infants born to mothers with anti-Ro
antibodies should be carefully monitored for hydrocephalus
as part of their routine physical examination
. Among the
babies in our SLE group, one had biliary atresia that could
possibly have been related to maternal SLE. Hepatobiliary
disease is a relatively common nding in NLE and can be
the sole clinical manifestation of NLE.
Our population-based study provides information on
maternal and neonatal outcomes in pregnancies complicated
by SLE to assist antenatal counselling and preparation of
parents for the birth of their babies. In addition to increased
pregnancy loss, there is an increased risk of earlier delivery,
delivery by Caesarean section, postpartum hemorrhage, and
postpartum fever, and a greater need for blood transfusion,
and. In the absence of congenital heart block, adverse
outcomes for babies are related to prematurity and its
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