CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF PREGNANT WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Objective. To provide the clinical and immunological characteristics of pregnant women with systemic lupus erythematosus (SLE) and to reveal the specific features of pregnancy, labor, and postpartum period. Subject and methods. The prospective study included 31 pregnant women aged 22 to 37years with Stage I-III SLE. During pregnancy, the women received cytostatics and corticosteroids. Clinical and immunological examination was done in the pregnant women; their history data and the specific features of pregnancy, labor, and postpartum period were analyzed; and the status of their newborn infants was evaluated. Flow cytofluorometry, indirect immunofluorescence, and enzyme immunoassay were used for immunological studies. Results. In the study group, the majority of the patients with SLE show long-lasting SLE, sustained remission prior to conception, high rates of injuries to the urinary and cardiovascular systems, skin and joints along with evident immunological and hematological changes. There is immune system dysregulation, an increase in the proportion of activated T lymphocytes and regulatory T cells, a decrease in the count of NK cells, a rise in serum immunoglobulins, IgA in particular; specific antinuclear antibodies are detectable. The obstetric histories show a high rate of spontaneous abortions, as well as perinatal losses. The women with SLE are noted to have increased rates of pregnancy, labor, and postpartum complications. The babies born to SLE women have lower weight and height than the general population and a high frequency of early neonatal complications. Conclusion. The right choice and timely correction of therapy for the underlying disease can prevent SLE complications and achieve a favorable pregnancy outcome in most women. An interdisciplinary follow-up of these patients in a third-level clinic with the participation of obstetricians, rheumatologists or therapists, nephrologists and pediatricians is recommended.

systemic lupus erythematosus, pregnancy, immune status, the specific features of pregnancy, obstetric complications