RESUMO
We aimed to assess the outcome of pregnancy in patients with systemic lupus erythematosus [SLE] and to evaluate clinical and laboratory markers for fetal outcome and maternal flares. Twenty-three patients were evaluated prospectively between 2000 and 2002. There were 27 [66%] live births, 8 [19%] spontaneous abortions, and 6 [15%] stillbirths. Of live born infant births, 8 [29%] were premature, 10 [38%] had suffered intrauterine growth restriction and one [3.7%] had neonatal lupus. Maternal lupus flares occurred in 33% of pregnancies, mostly in the second trimester [23%] and in the post-partum period [49%]. Flares during pregnancy showed a statistically significant association with discontinuation of hydroxychloroquine treatment, a history of more than three flares before gestation and a SLEDAT [Systemic lupus Erythematosus Disease Activity Index] score of 5 in these flares. Antiphospholipid antibodies, C3 hypocomplementaemia and hypertension during pregnancy were significantly associated with fetal loss, prematurity and intrauterine growth restriction. Patients with more active SLE and those with aPL antibodies and hypertension should be monitored and managed carefully during pregnancy