Risk factors in the pregnancy of patients with systemic lupus erythematosus: association of hypocomplementaemia with poor prognosis

• Published in: Annals of the rheumatic diseases Vol. 51; no. 5; pp. 619 - 623
• Main Authors: Shibata, S, Sasaki, T, Hirabayashi, Y, Seino, J, Okamura, K, Yoshinaga, K, Morito, N, Kasukawa, R, Aotuka, S, Yokohari, R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.05.1992; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Antibodies - analysis; Biological and medical sciences; Complement System Proteins - metabolism; Female; Fetal Death; Humans; Lupus Erythematosus, Systemic - blood; Lupus Erythematosus, Systemic - immunology; Medical sciences; Phospholipids - immunology; Pregnancy; Pregnancy Outcome; Prognosis; Retrospective Studies; Risk Factors; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Human; Skin disease; Prognosis; Autoimmune disease; Complement; Pregnancy; Hypocomplementemia; Risk factor; Systemic disease; Fetus; Lupus erythematosus; Death; Disseminated
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.51.5.619

Fetal wastage is still high in the pregnancies of patients with systemic lupus erythematosus (SLE). We examined retrospectively the cases of 38 patients with inactive SLE in whom pregnancy was either desired or had already been obtained. The prevalence of antiphospholipid antibodies in the group with fetal loss was high. The antibodies were, however, also detected in five of 14 patients who had had a live birth. It was noted that low levels of serum complement activity (CH50 less than 25 U/ml) occurred in five of six patients with fetal loss, but in only two of 22 with a live birth. Serial studies also confirmed a close association between decreased serum complement activity and poor fetal prognosis in lupus pregnancy. Treatment with increased doses of prednisolone may help to achieve successful live births. Thus hypocomplementaemia may be associated with a worse prognosis for the fetus in the pregnancies of some patients with SLE in remission.