Incidence and associated factors of the most common obstetric complications in pregnant patients with systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease predominantly affecting women of reproductive age, presenting significant challenges during pregnancy. This condition can lead to serious obstetric complications for both mother and fetus. Objectives: To determine the incidence and associated factors of obstetric complications in pregnant patients with systemic lupus erythematosus. Material and Method: A retrospective, observational, analytical, and cross-sectional study was conducted, comprising 106 pregnant patients diagnosed with systemic lupus erythematosus. Results: The mean age of the patients was 32 years (range: 19–39 years). The incidence of obstetric complications was 30%, including preeclampsia (20.8%), HELLP syndrome (3.8%), intrauterine growth restriction (IUGR) (13.2%), and preterm birth (23.6%). Perinatal mortality was 10.4%. High lupus activity in the first trimester was associated with preeclampsia (OR = 2.38, 95% CI: 1.23–4.59, p = 0.011), while increased activity in the third trimester was linked to IUGR (OR = 2.05, 95% CI: 1.04–4.05, p = 0.037). Prednisone use >10 mg/day increased the risk of maternal infections (OR = 2.72, 95% CI: 1.30–5.70, p = 0.008), whereas hydroxychloroquine use was associated with a reduced incidence of preeclampsia (OR = 0.45, 95% CI: 0.21–0.97, p = 0.033). Conclusions: The incidence of obstetric complications in patients with SLE is high, necessitating early and continuous monitoring of disease activity. Optimizing treatment, including hydroxychloroquine use and careful management of prednisone, can significantly improve maternal and perinatal outcomes.