SLE Pregnancy Complications — SCE Rheumatology MCQ

Correct answer: D — Pre-eclampsia, preterm birth, fetal growth restriction, pregnancy loss and neonatal lupus

Explanation lettering: E = shown as A · A = shown as B · B = shown as D · D = shown as E

SLE pregnancies have increased risks of pre-eclampsia, preterm birth, fetal growth restriction and pregnancy loss. Adverse outcomes are more likely with active disease at conception, lupus nephritis, chronic hypertension or antiphospholipid antibodies/APS. Maternal anti-Ro/SSA or anti-La/SSB antibodies confer a risk of neonatal lupus, particularly congenital heart block and cutaneous disease. Pregnancy should therefore ideally be planned during stable, inactive disease with preconception assessment of renal function and relevant antibodies. Options A, C, D and E describe complication clusters more characteristic of diabetes, abnormal placental implantation, cervical insufficiency and red-cell alloimmunisation respectively, rather than the characteristic SLE pregnancy-risk profile.

Reference: Andreoli L et al. EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017;76:476–485. https://pubmed.ncbi.nlm.nih.gov/27457513/