Table 4.

Case series.

Reference, year of publication	Case	Age (y)	BEL exposure of the neonate	Concomitant medication during pregnancy	Maternal outcome	Foetal outcome
Danve et al, 2014 11	1 (1st pregnancy)	38	Conception to 32nd week	PSL + HCQ + BEL + LWMH	No incidents	Alive, term. Mild Ebstein’s anomaly
Kumthekar a et al, 2017 12	1 (2nd pregnancy)	40				Miscarriage because of aneuploidy
	1 (3rd pregnancy)	41	Conception to 33rd week	PSL + HCQ + BEL + LWMH	No incidents	Alive, term. Extrarenal pelvis, which is considered a normal anatomic variant
Emmi G et al. 2016 13	2	24	Conception to 24th week	PSL + HCQ + BEL		Alive, term, caesarean section
Bitter H et al 2018, 14 2023, 15	3	29	Conception to 26th week	AZA + HCQ + BEL	No incidents	Alive, term (40 weeks); reduced T-cell subsets at birth
Chehab G et al 2019 16	4	32	Conception to early pregnancy (not specified)	PSL 5 mg/day + HCQ + AZA + LDA + LMWH	PPROM	Alive, preterm (32 weeks). Twins, both with umbilical hernias
Gandino IJ et al. 2021 17	5	27	Conception to 12th week	PSL + HCQ	No incidents	Alive, term (39 + 6weeks), caesarean section due to oligohydramnios and lack of adequate progression
Kao JH, et al, 2021 18	6	38	3rd trimester	LDA + HCQ + PSL + AZA + BEL	No incidents	Alive, term
	7	32	3rd trimester	LDA + HCQ + PSL + BEL	PPROM, APH	Alive, preterm (31 + 4weeks), LBW (1594 g), and RDS
	8	48	1st and 2nd trimester	LDA + HCQ + PSL+ AZA + LMWH + BEL	No incidents	Alive, preterm (35 + 3weeks) IUGR and LBW
	9	38	3rd trimester	LDA + HCQ + PSL + AZA + BEL	APH	Alive, preterm (32 + 4weeks), LBW (2216 g), and RDS
	10	31	1st, 2nd and 3rd trimester	LDA + HCQ + PSL + AZA + LMWH + IVIg + BEL	PPROM	Alive, preterm (33 + 1week), LBW (1774 g)
	11	31	1st and 3rd trimester	LDA + HCQ + PSL + BEL	Gestational diabetes mellitus	Alive, term (38 + 2weeks)
	12	41	2 nd trimester	LDA + HCQ + PSL + AZA + IVIg + BEL	No incidents	Miscarriage (18 weeks)
	13	48	3 rd trimester	LDA + HCQ + PSL + AZA + LMWH + BEL	No incidents	Miscarriage (15 + 4weeks)
	14	46	1st, 2nd and 3rd trimester	LDA + HCQ + PSL + AZA + LMWH + IVIg + BEL	Preeclampsia, placenta accreta	Alive, preterm (34 + 4weeks), RDS
	15	37	3 rd trimester	LDA + HCQ + PSL + AZA + SASP + BEL	No incidents	- Twin A: Alive, term (37 + 1week), LBW (2266 g), RDS, omphalitis - Twin B: Alive, term (37 + 1week), LBW (1870 g)
	16	31	3 rd trimester	LDA + HCQ + PSL + AZA + LMWH + BEL	PPROM	Alive, preterm (36 + 6weeks), LBW (2424 g)
	17	43	2 nd , and 3 rd trimester	LDA + HCQ + PSL + AZA + BEL	No incidents	- Twin A: Alive, preterm (31 + 6weeks), LBW (1250 g), RDS - Twin B: Alive, preterm (31 + 6) weeks, LBW (1402 g), RDS, and neonatal jaundice
	18	37	3rd trimester	LDA + HCQ + PSL + AZA + IVIg + BEL	No incidents	Alive, preterm (36 + 5weeks), LBW (2282 g)
Crisafulli F et al, 2021 19	19 – 31 (aggregated data)	32 [range 24-41]	2: Stopped before conception 7: Stopped at positive pregnancy test 2: Conception to 11th week 1: Conception to 22ndweek 1: Conception to 24th week	12 PD; 1 IV PSL; 10 HCQ; 1 chloroquine; 5 AZA; 5 calcineurin inhibitors; 10 LDA; 9 LMWH.	3 flares; 1 preeclampsia, 1 eclampsia, 1 PPROM, 1 gestational diabetes	1 late miscarriage, 12 live birth (4 preterm), 2 IUGR, 5 SGA, 1 perinatal death. No malformations
Lai Y et al, 2022 20	32	34	Conception to 4th week	PD + immunosuppressants + sildenafil	HTN, LN, preeclampsia	Alive, preterm (28 weeks), caesarean section, LBW (950 g)
	33	32	13 to 18th week	PD + HCQ + CsA	HTN, LN, preeclampsia	Alive, preterm, caesarean section (33 + 5weeks) LBW (1800 g)
	34	34	9th week to end	PD + HCQ + TAC + LDA + propylthiouracil	Mild thrombopenia	Alive, term (37 + 3weeks), caesarean section due to LFW
	35	37	23rd week to end	PD + HCQ + TAC + LDA + LMWH	No incidents	Alive, term (39 weeks)
Wei SR, et al, 2023 21	36	37	14 to 36th week	PD + HCQ + TAC + alfacalcidol	No incidents	Alive, term (37 + 6weeks), LBW (2420 g)
	37	25	12 to 35th week	PSL + HCQ + CsA	No incidents	Alive, term (37 + 6weeks)
Nakai T et al, 2023 22	38	27	Conception to 5th week	PSL + BEL + TAC	Pregnancy hypertension	Alive, term (37 + 1week), SGA, LBW (1876 g)
	39	32	Conception to 7th week	PSL + BEL + TAC + HCQ	No incidents	Missed abortion

APH; antepartum haemorrhage; AZA, azathioprine; BEL, belimumab; CsA, cyclosporine A; HCQ, hydroxychloroquine; HTN, secondary hypertension; IVIg, intravenous immunoglobulin therapy; LBW, low birth weight; LDA, low dose aspirin; LFW, loss of foetal wellbeing; LMWH, low molecular weight heparin; LN, lupus nephritis; PAH, pulmonary arterial hypertension; PD, prednisone; PSL, prednisolone; PPROM, premature rupture of membrane; RDS, respiratory distress syndrome; SASP, sulfasalazine; SLE, systemic lupus erythematosus; SGA, small for gestational age; TAC, tacrolimus; Y: years.