What is the number one complication of systemic lupus erythematosus (SLE) in pregnancy?

The number one complication of systemic lupus erythematosus (SLE) in pregnancy is preterm birth. Women with SLE are at an increased risk for prematurity due to several factors including disease activity, inflammation, and potential complications associated with pregnancy.

During pregnancy, the presence of SLE can impact fetal health by leading to complications such as inflammation of the placental tissue, which can trigger early labor. Moreover, women with active lupus or certain associated factors, like antiphospholipid syndrome, have a higher likelihood of adverse pregnancy outcomes that may result in preterm delivery.

While gestational diabetes, preeclampsia, and placental abruption are important concerns in pregnancies complicated by SLE, research indicates that preterm birth is the most prevalent and significant concern during such pregnancies. The management of these patients typically focuses on minimizing disease activity and careful monitoring to mitigate the risks of these complications, particularly the risk of preterm birth.