%0 Journal Article
%T Does cutaneous lupus erythematosus have more favorable pregnancy outcomes than systemic disease? A two-center study.
%A Hamed HO
%A Ahmed SR
%A Alzolibani A
%A Kamal MM
%A Mostafa MS
%A Gamal RM
%A Atallah DA
%A Abd-El-Aall DE
%J Acta Obstet Gynecol Scand
%V 92
%N 8
%D Aug 2013
%M 23621378
%F 4.544
%R 10.1111/aogs.12158
%X <B>OBJECTIVE: </B>To compare pregnancy outcomes in cutaneous lupus erythematosus (CLE) with systemic lupus erythematosus (SLE) and healthy pregnant women.<BR><B>METHODS: </B>Cohort comparative study.<BR><B>METHODS: </B>Two university maternity centers in Saudi Arabia and Egypt.<BR><B>METHODS: </B>Pregnant women with CLE and SLE and healthy pregnant women.<BR><B>METHODS: </B>Over a three-year period, 201 participants were allocated to three groups: group 1 (n = 67) contained women with CLE, group 2 (n = 67) women with SLE, and group 3 healthy controls (n = 67). Diagnosis of lupus erythematosus was based on American College of Rheumatology criteria. All participants were followed until delivery. Lupus exacerbation was evaluated by Lupus Activity Index score. ANOVA and chi-squared tests were used to compare obstetrical and neonatal outcomes, and regression analysis was used to define independent factors of adverse pregnancy outcomes.<BR><B>METHODS: </B>Pregnancy losses, preterm labor, intrauterine growth restriction, preeclampsia, neonatal intensive care unit admissions, cesarean sections and lupus exacerbations.<BR><B>RESULTS: </B>There was no significant difference between groups 1 and 3 in rates of pregnancy loss, preterm labor, preeclampsia, intrauterine growth restriction and neonatal intensive care admission. Group 1 had lower pregnancy loss (p = 0.005), growth restriction (p = 0.001), preeclampsia (p = 0.05), neonatal intensive care admissions (p = 0.001), cesarean section (p = 0.03), lupus exacerbations (p = 0.05) and anti-phospholipid antibodies (p = 0.02) compared with group 2. In groups 1 and 2, lupus exacerbation and anti-phospholipid antibodies were significant independent factors for adverse outcomes.<BR><B>CONCLUSIONS: </B>Cutaneous lupus erythematosus means comparable pregnancy outcomes to those of the healthy population. Lower rates of disease exacerbation and anti-phospholipid antibodies are potential factors for better pregnancy outcome in CLE compared with SLE.