{Reference Type}: Journal Article
{Title}: Does cutaneous lupus erythematosus have more favorable pregnancy outcomes than systemic disease? A two-center study.
{Author}: Hamed HO;Ahmed SR;Alzolibani A;Kamal MM;Mostafa MS;Gamal RM;Atallah DA;Abd-El-Aall DE;
{Journal}: Acta Obstet Gynecol Scand
{Volume}: 92
{Issue}: 8
{Year}: Aug 2013
{Factor}: 4.544
{DOI}: 10.1111/aogs.12158
{Abstract}: OBJECTIVE: To compare pregnancy outcomes in cutaneous lupus erythematosus (CLE) with systemic lupus erythematosus (SLE) and healthy pregnant women.
METHODS: Cohort comparative study.
METHODS: Two university maternity centers in Saudi Arabia and Egypt.
METHODS: Pregnant women with CLE and SLE and healthy pregnant women.
METHODS: 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.
METHODS: Pregnancy losses, preterm labor, intrauterine growth restriction, preeclampsia, neonatal intensive care unit admissions, cesarean sections and lupus exacerbations.
RESULTS: 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.
CONCLUSIONS: 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.