Objective. To compare pregnancy outcomes in cutaneous lupus erythematosus (CLE) with sys
temic lupus erythematosus (SLE) and healthy pregnant women. Design. Cohort comparative
study.
Setting. Two
university
maternity
centers
in
Saudi
Arabia
and
Egypt.
Popula
tion. Pregnant women with CLE and SLE and healthy pregnant women. Methods. Over a
=
three-year period, 201 participants were allocated to three groups: group 1 (n
67) contained
=
=
women with CLE, group 2 (n
67) women with SLE, and group 3 healthy controls (n
67).
Diagnosis of lupus erythematosus was based on American College of Rheumatology criteria.
All participants were followed until delivery. Lupus exacerbation was evaluated by Lupus
Activity Index score. ANOVA and chi-squared tests were used to compare obstetrical and neo
natal outcomes, and regression analysis was used to define independent factors of adverse
pregnancy outcomes. Main outcome measures. Pregnancy losses, preterm labor, intrauterine
growth restriction, preeclampsia, neonatal intensive care unit admissions, cesarean sections
and lupus exacerbations. Results. There was no significant difference between groups 1 and 3
in rates of pregnancy loss, preterm labor, preeclampsia, intrauterine growth restriction and
=
neonatal intensive care admission. Group 1 had lower pregnancy loss (p
0.005), growth
=
=
restriction
(p
0.001),
preeclampsia
(p
0.05),
neonatal
intensive
care
admissions
=
=
=
(p
0.001), cesarean section (p
0.03), lupus exacerbations (p
0.05) and anti-phospholipid
=
antibodies (p
0.02) compared with group 2. In groups 1 and 2, lupus exacerbation and
anti-phospholipid antibodies were significant independent factors for adverse outcomes.
Conclusions. Cutaneous lupus erythematosus means comparable pregnancy outcomes to those
of the healthy population. Lower rates of disease exacerbation and anti-phospholipid antibod
ies are potential factors for better pregnancy outcome in CLE compared with SLE.