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Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1992 May;51(5):619–623. doi: 10.1136/ard.51.5.619

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

S Shibata 1, T Sasaki 1, Y Hirabayashi 1, J Seino 1, K Okamura 1, K Yoshinaga 1, N Morito 1, R Kasukawa 1, S Aotuka 1, R Yokohari 1
PMCID: PMC1005693  PMID: 1616326

Abstract

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.

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Selected References

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  1. Branch D. W., Scott J. R., Kochenour N. K., Hershgold E. Obstetric complications associated with the lupus anticoagulant. N Engl J Med. 1985 Nov 21;313(21):1322–1326. doi: 10.1056/NEJM198511213132104. [DOI] [PubMed] [Google Scholar]
  2. Budman D. R., Merchant E. B., Steinberg A. D., Doft B., Gershwin M. E., Lizzio E., Reeves J. P. Increased spontaneous activity of antibody-forming cells in the peripheral blood of patients with active SLE. Arthritis Rheum. 1977 Apr;20(3):829–833. doi: 10.1002/art.1780200312. [DOI] [PubMed] [Google Scholar]
  3. Devoe L. D., Loy G. L. Serum complement levels and perinatal outcome in pregnancies complicated by systemic lupus erythematosus. Obstet Gynecol. 1984 Jun;63(6):796–800. [PubMed] [Google Scholar]
  4. Fort J. G., Cowchock F. S., Abruzzo J. L., Smith J. B. Anticardiolipin antibodies in patients with rheumatic diseases. Arthritis Rheum. 1987 Jul;30(7):752–760. doi: 10.1002/art.1780300705. [DOI] [PubMed] [Google Scholar]
  5. Hanly J. G., Gladman D. D., Rose T. H., Laskin C. A., Urowitz M. B. Lupus pregnancy. A prospective study of placental changes. Arthritis Rheum. 1988 Mar;31(3):358–366. doi: 10.1002/art.1780310307. [DOI] [PubMed] [Google Scholar]
  6. Harris E. N., Gharavi A. E., Boey M. L., Patel B. M., Mackworth-Young C. G., Loizou S., Hughes G. R. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet. 1983 Nov 26;2(8361):1211–1214. doi: 10.1016/s0140-6736(83)91267-9. [DOI] [PubMed] [Google Scholar]
  7. Harris E. N., Gharavi A. E., Hughes G. R. Anti-phospholipid antibodies. Clin Rheum Dis. 1985 Dec;11(3):591–609. [PubMed] [Google Scholar]
  8. Hughes G. R., Harris N. N., Gharavi A. E. The anticardiolipin syndrome. J Rheumatol. 1986 Jun;13(3):486–489. [PubMed] [Google Scholar]
  9. Liang M. H., Socher S. A., Larson M. G., Schur P. H. Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. Arthritis Rheum. 1989 Sep;32(9):1107–1118. doi: 10.1002/anr.1780320909. [DOI] [PubMed] [Google Scholar]
  10. Lockshin M. D. Lupus pregnancy. Clin Rheum Dis. 1985 Dec;11(3):611–632. [PubMed] [Google Scholar]
  11. Lockshin M. D., Qamar T., Druzin M. L. Hazards of lupus pregnancy. J Rheumatol Suppl. 1987 Jun;14 (Suppl 13):214–217. [PubMed] [Google Scholar]
  12. Lockshin M. D., Reinitz E., Druzin M. L., Murrman M., Estes D. Lupus pregnancy. Case-control prospective study demonstrating absence of lupus exacerbation during or after pregnancy. Am J Med. 1984 Nov;77(5):893–898. doi: 10.1016/0002-9343(84)90538-2. [DOI] [PubMed] [Google Scholar]
  13. Lubbe W. F., Butler W. S., Palmer S. J., Liggins G. C. Fetal survival after prednisone suppression of maternal lupus-anticoagulant. Lancet. 1983 Jun 18;1(8338):1361–1363. doi: 10.1016/s0140-6736(83)92141-4. [DOI] [PubMed] [Google Scholar]
  14. Morrow W. J., Isenberg D. A., Parry H. F., Snaith M. L. C-reactive protein in sera from patients with systemic lupus erythematosus. J Rheumatol. 1981 Jul-Aug;8(4):599–604. [PubMed] [Google Scholar]
  15. Petri M., Rheinschmidt M., Whiting-O'Keefe Q., Hellmann D., Corash L. The frequency of lupus anticoagulant in systemic lupus erythematosus. A study of sixty consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anticardiolipin antibody level. Ann Intern Med. 1987 Apr;106(4):524–531. doi: 10.7326/0003-4819-106-4-524. [DOI] [PubMed] [Google Scholar]
  16. Pincus T., Schur P. H., Rose J. A., Decker J. L., Talal N. Measurement of serum DNA-binding activity in systemic lupus erythematosus. N Engl J Med. 1969 Sep 25;281(13):701–705. doi: 10.1056/NEJM196909252811304. [DOI] [PubMed] [Google Scholar]
  17. Smolen J. S., Chused T. M., Leiserson W. M., Reeves J. P., Alling D., Steinberg A. D. Heterogeneity of immunoregulatory T-cell subsets in systemic lupus erythematosus. Correlation with clinical features. Am J Med. 1982 May;72(5):783–790. doi: 10.1016/0002-9343(82)90544-7. [DOI] [PubMed] [Google Scholar]
  18. Systemic lupus erythematosus in pregnancy. Ann Intern Med. 1981 May;94(5):667–677. doi: 10.7326/0003-4819-94-5-667. [DOI] [PubMed] [Google Scholar]
  19. Tozman E. C., Urowitz M. B., Gladman D. D. Systemic lupus erythematosus and pregnancy. J Rheumatol. 1980 Sep-Oct;7(5):624–632. [PubMed] [Google Scholar]
  20. Unander A. M., Norberg R., Hahn L., Arfors L. Anticardiolipin antibodies and complement in ninety-nine women with habitual abortion. Am J Obstet Gynecol. 1987 Jan;156(1):114–119. doi: 10.1016/0002-9378(87)90218-3. [DOI] [PubMed] [Google Scholar]

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