Godište 35 supplement 2 - Institut za reumatologiju

6. Clark CA, Spitzer JN, Nadler JN, Laskin CA. Preterm deliveries in women with systemic lupus
erythematosus. J. Rheumatol 2003Č30_2127-2132.
7. Di Simone N, Meroni PL, Del Papa N. Antiphospholipid antibodies affect trophoblast
gonadotropin secretion and invasiveness by binding directly and trough adhered beta2glicoprotein
I. Arthritis Rheum 2000;43:140-150.
8. Laskin CA, Clark CA, Spitzer KA. Antiphospholipid syndrome in systemic lupus erythematosus:
is the whole greater than the sum of its parts? Rheum Dis Clin N Am 2005;31:255-272.
9. Buyon JP, Clancy RM. Neonatal lupus: basic research and clinical perspectives. Rheum Dis Clin
N Am 2005;31:299-313.
10. Costedoat-Chalumeau N, Amoura Z, Duhaut P, Huong DLT. et al. Safety of hydroxychloroquine
in pregnant patients with connective tissue disease. A study of one hundred thirty-three case
compared with a control group. Arthritis Rheum 2003;48:3207-3211.
11. Derksen RHW, Khamashta MA, Branch DW. Management of the obstetric antiphospholipid
syndrome. Arthritis Rheum 2004;50:1028-1039.
_______________________
S U M M A R Y
Institute of Rheumatology – Belgrade
SYSTEMIC LUPUS ERYTHEMATOSUS AND PREGNANCY
RADMILA PETROVIĆ
Pregnancy in patient with systemic lupus erythematosus confers a risk of numerous complications
affecting pregnancy outcome and health of both woman and neonate. Data about the influence of
pregnancy on systemic lupus are controversial, but recent prospective studies indicate that quiescent
disease at conception reduces risk of severe flare during pregnancy, the most frequently occurring at II
and III trimester or after delivery. Conversely, pregnant patients with systemic lupus have increased rate
of obstetric complications that include fetal loss, prematurity, preeclampsia, intrauterine growth
retardation and neonatal lupus syndromes. Some clinical and immunoserological features of systemic
lupus erythematosus are predictive factors for pregnancy complications. There is a clear evidence-based
association between maternal anti-Ro (SSA-A) antibodies and congenital heart block or neonatal lupus.
Antiphospholipid antibodies and secondary antiphospholipid syndrome are most frequent risk factors that
implicate fetal loss and other pregnancy complications, but active lupus and nephritis have also been
associated with poor fetal and maternal outcome. Good disease control before pregnancy, coordinated
surveillance by obstetrician and rheumatologist during pregnancy and treatment according to
reccomendations for management of obstetric antiphospholipid syndrome or congenital heart block
improve pregnancy outcome in patients with systemic lupus erythematosus.
Key words: systemic lupus erythematosus, pregnancy outcome,antiphospholipid syndrome, neonatal
lupus