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Systemic lupus erythematosus: strategies to improve pregnancy outcomes

Authors Yamamoto Y, Aoki S

Received 28 February 2016

Accepted for publication 11 May 2016

Published 8 July 2016 Volume 2016:8 Pages 265—272


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Elie Al-Chaer

Yuriko Yamamoto, Shigeru Aoki

Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa Prefecture, Japan

Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high prevalence in females of childbearing age. Thus, reproduction in SLE patients is a major concern for clinicians. In the past, SLE patients were advised to defer pregnancy because of poor pregnancy outcomes and fear of SLE flares during pregnancy. Investigations to date show that maternal and fetal risks are higher in females with SLE than in the general population. However, with appropriate management of the disease, sufferers may have a relatively uncomplicated pregnancy course. Factors such as appropriate preconception counseling and medication adjustment, strict disease control prior to pregnancy, intensive surveillance during and after pregnancy by both the obstetrician and rheumatologist, and appropriate interventions when necessary play a key role. This review describes the strategies to improve pregnancy outcomes in SLE patients at different time points in the reproduction cycle (preconception, during pregnancy, and postpartum period) and also details the neonatal concerns.

Keywords: systemic lupus erythematosus, pregnancy outcomes, lupus flare

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