Pregnancy in Systemic Lupus Erythematosus: Achieving Low Disease Activity and Improving Maternal-Fetal Prognosis

Systemic lupus erythematosus (SLE) significantly impacts family planning for women of reproductive age, with risks of disease exacerbation and maternal-fetal complications complicating pregnancy decisions. This review synthesizes current literature on pregnancy outcomes in women with SLE, emphasizing the importance of achieving low disease activity before conception. The data reveal a nuanced landscape of pregnancy risks, including increased rates of preeclampsia, premature birth, and fetal loss, alongside varied effects of SLE medications on both maternal and fetal health. Notably, biological therapies like hydroxychloroquine show promise in reducing adverse outcomes. Despite advancements in understanding, notable gaps remain in patient beliefs and comprehensive pregnancy planning strategies for this cohort. This manuscript advocates for enhanced interdisciplinary collaboration between rheumatologists and obstetricians, highlighting regular counseling on fertility, medication management, and risk assessment to optimize maternal and newborn health outcomes. Future research should focus on real-world experiences and perceptions of women with SLE regarding pregnancy planning to inform clinical guidelines and improve patient care.