Division of Rheumatology, University Medicine Cluster, National University Health System, 1E, Kent Ridge Road, 119074, Singapore.
Nat Rev Rheumatol. 2012 Dec;8(12):710-8. doi: 10.1038/nrrheum.2012.133. Epub 2012 Aug 21.
Systemic lupus erythematosus (SLE) is an autoantibody-mediated systemic autoimmune disease, predominantly affecting young females. Pregnancy is increasingly common in the setting of SLE, as survival and quality of life of patients improve. Although live births can be achieved in the most cases, pregnancy in patients with SLE remains a high-risk condition. Maternal and fetal mortality and morbidity are considerably increased, compared with the general population. Aberrations in pregnancy-related maternal immune adaptations are likely contributors. Active maternal disease, renal involvement, specific autoantibody subsets and advanced organ damage are predictors of poor outcome. Therapeutic options are limited during pregnancy as maternal benefit has to be weighed against fetal risk. Prevention of preterm birth and refractory pregnancy loss, as well as management of established neonatal heart block remain unmet needs. Further research should address these important issues that affect young patients with SLE and their babies.
系统性红斑狼疮（SLE）是一种自身抗体介导的系统性自身免疫性疾病，主要影响年轻女性。随着患者的生存和生活质量的提高，SLE 患者的妊娠越来越常见。尽管大多数情况下都可以实现活产，但 SLE 患者的妊娠仍然是一种高风险情况。与普通人群相比，母亲和胎儿的死亡率和发病率显著增加。妊娠相关母体免疫适应异常可能是导致这种情况的原因之一。母亲疾病活动、肾脏受累、特定自身抗体亚群和晚期器官损伤是不良结局的预测因素。由于需要权衡母亲的获益与胎儿的风险，因此在怀孕期间治疗选择有限。预防早产和难治性流产以及治疗已确诊的新生儿心脏传导阻滞仍然是未满足的需求。进一步的研究应该解决这些影响年轻 SLE 患者及其婴儿的重要问题。
