Pathogenesis of pregnancy complications in systemic lupus erythematosus.

Published

Journal Article (Review)

PURPOSE OF REVIEW: In spite of the advances made in the management of pregnancies in women with systemic lupus erythematosus (SLE), maternal complications and adverse fetal outcomes still exceed the rate of pregnancy complications in the general population. An intriguing question relates to the observation that pregnancy loss, intrauterine growth restriction (IUGR), preterm birth, and preeclampsia remain major complications in SLE pregnancies, not substantially altered by improved therapy and monitoring. RECENT FINDINGS: From the review of the recent literature on the pathogenesis of pregnancy loss, IUGR, preeclampsia, and prematurity, it appears that clinical or subclinical inflammation, presence of autoantibodies, hormonal dysfunction, and immune alterations of lupus contribute to pregnancy complications. Impairment of early placenta development leads to poor vascularization, resulting in placental ischemia and subsequent endothelial damage. Depending on the extent of the pathological process, pregnancy loss, IUGR, and preeclampsia can develop. SUMMARY: Early recognition of pregnancy complications is desirable in order to prevent their development or to prompt intervention that improves the outcomes. Several biomarkers have been investigated for their ability to predict complications at an early stage of pregnancy. However, up to date only lupus anticoagulant has emerged as a consistent predictor for adverse pregnancy outcomes.

Full Text

Duke Authors

Cited Authors

  • Ostensen, M; Clowse, M

Published Date

  • September 2013

Published In

Volume / Issue

  • 25 / 5

Start / End Page

  • 591 - 596

PubMed ID

  • 23917157

Pubmed Central ID

  • 23917157

Electronic International Standard Serial Number (EISSN)

  • 1531-6963

Digital Object Identifier (DOI)

  • 10.1097/BOR.0b013e328363ebf7

Language

  • eng

Conference Location

  • United States