Department of Rheumatiod and Immunology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, China.
Arch Gynecol Obstet. 2023 Jul;308(1):63-71. doi: 10.1007/s00404-022-06718-7. Epub 2022 Aug 1.
Systemic lupus erythematosus (SLE)-a most common disorder in women of reproductive age-has been described to be associated with adverse pregnancy outcomes. Despite the increased health risks for the mother (preeclampsia, lupus flare, arterial hypertension, gestational diabetes mellitus and thrombotic risk when antiphospholipid antibodies are present) and fetus (miscarriage, stillbirth, premature birth, intrauterine growth restriction and neonatal lupus), the majority of patients can deliver healthy neonates. With appropriate management by a multidisciplinary team, composing rheumatologists, obstetricians and neonatologists, women with SLE can achieve better pregnancy outcomes by monitoring associated predictive indicators, raising major concern for severe complications and somewhat early delivery if necessary. In this review, we summarize the latest advances in secondary infertility and pregnancy-related risk perception for lupus patients, with an emphasis on the safety of biological agents (mainly belimumab and rituximab) and traditional therapeutic regimens.
系统性红斑狼疮（SLE）是育龄妇女中最常见的疾病之一，已被描述为与不良妊娠结局相关。尽管母亲（子痫前期、狼疮发作、动脉高血压、妊娠期糖尿病和存在抗磷脂抗体时的血栓形成风险）和胎儿（流产、死产、早产、宫内生长受限和新生儿狼疮）的健康风险增加，但大多数患者仍能生育健康的新生儿。通过由风湿病学家、产科医生和新生儿科医生组成的多学科团队的适当管理，SLE 患者可以通过监测相关预测指标、对严重并发症提出重大关注并在必要时提前分娩来实现更好的妊娠结局。在这篇综述中，我们总结了狼疮患者继发性不孕和与妊娠相关的风险认知的最新进展，重点关注生物制剂（主要是贝利尤单抗和利妥昔单抗）和传统治疗方案的安全性。
