{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:57:00Z","timestamp":1785452220716,"version":"3.56.0"},"reference-count":46,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to examine the frequency and risk factors of complications during pregnancy in women with systemic lupus erythematosus (SLE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of patients with SLE and age-matched controls at Ajou University Hospital were collected. Clinical features and pregnancy complications in women with SLE were compared to those of the controls. Multivariate logistic regression analysis was performed to determine the predictors of adverse maternal and fetal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed 163 pregnancies in patients with SLE and 596 pregnancies in the general population; no significant differences regarding demographic characteristics were noted. Patients with SLE experienced a higher rate of stillbirth (OR 13.2), preeclampsia (OR 4.3), preterm delivery (OR 2.8), intrauterine growth retardation (OR 2.5), admission to neonatal intensive care unit (OR 2.2), and emergency cesarean section (OR 1.9) than the control group. Multivariate regression analysis revealed that thrombocytopenia, low complement, high proteinuria, high SLE Disease Activity Index (SLEDAI), low Lupus Low Disease Activity State (LLDAS) achievement rate, and high corticosteroid (CS) dose were associated with adverse pregnancy outcomes. In the receiver-operating characteristic curve analysis, the optimal cutoff value for the cumulative and mean CS doses were 3500 mg and 6 mg, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pregnant women with SLE have a higher risk of adverse pregnancy outcomes. Pregnancies are recommended to be delayed until achieving LLDAS and should be closely monitored with the lowest possible dose of CS.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.200802","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T16:21:28Z","timestamp":1602778888000},"page":"707-716","source":"Crossref","is-referenced-by-count":41,"title":["Lupus Low Disease Activity State Achievement Is Important for Reducing Adverse Outcomes in Pregnant Patients With Systemic Lupus Erythematosus"],"prefix":"10.3899","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2827-0884","authenticated-orcid":false,"given":"Ji-Won","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-0795","authenticated-orcid":false,"given":"Ju-Yang","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-3367","authenticated-orcid":false,"given":"Hyoun-Ah","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong I.","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong W.","family":"Kwak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-393X","authenticated-orcid":false,"given":"Chang-Hee","family":"Suh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2020,10,15]]},"reference":[{"key":"2022062303401358000_48.5.707.1","first-page":"1868","article-title":"Pregnancy outcomes in systemic lupus erythematosus (SLE) women","volume":"40","author":"Kalok","year":"2019","journal-title":"Horm Mol Biol Clin Investig"},{"key":"2022062303401358000_48.5.707.2","unstructured":"Petri M , Kallas R. Lupus in pregnancy. Contemp Ob Gyn 2019;64 No 03. [Internet. Accessed January 21, 2021.] Available from: www.contemporaryobgyn.net\/pregnancy-and-birth\/lupus-pregnancy"},{"key":"2022062303401358000_48.5.707.3","unstructured":"Ordi-Ros J , Marce CS , Cortes-Hernandez J. Lupus pregnancy: risk factors and management. In: Lionaki S , ed. Lupus \u2013 new advances and challenges. [Internet. Accessed February 8, 2021.] Available from: www.intechopen.com\/books\/lupus-new-advances-and-challenges\/lupus-pregnancy-risk-factors-and-management"},{"key":"2022062303401358000_48.5.707.4","doi-asserted-by":"crossref","unstructured":"Chakravarty EF , Sammaritano LR. Pregnancy and autoimmune disease, reproductive and hormonal issues. In: Wallace D , Hahn B. Dubois\u2019 lupus erythematosus and related syndromes 9th ed. Elsevier; 2019:499-519.","DOI":"10.1016\/B978-0-323-47927-1.00040-2"},{"key":"2022062303401358000_48.5.707.5","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1002\/art.1780341210","article-title":"Frequency of lupus flare in pregnancy: the Hopkins Lupus Pregnancy Center experience","volume":"34","author":"Petri","year":"1991","journal-title":"Arthritis Rheum"},{"key":"2022062303401358000_48.5.707.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.063"},{"key":"2022062303401358000_48.5.707.7","doi-asserted-by":"crossref","first-page":"131","DOI":"10.7326\/L15-0500","article-title":"Predictors of pregnancy outcomes in patients with lupus","volume":"164","author":"Buyon","year":"2016","journal-title":"Ann Intern Med"},{"key":"2022062303401358000_48.5.707.8","doi-asserted-by":"crossref","first-page":"128","DOI":"10.4103\/0973-3698.194546","article-title":"Fertility and pregnancy in systemic lupus erythematosus","volume":"11","author":"Jones","year":"2016","journal-title":"Indian J Rheumatol"},{"key":"2022062303401358000_48.5.707.9","doi-asserted-by":"crossref","first-page":"885","DOI":"10.2147\/TCRM.S160760","article-title":"Management and outcomes of pregnancy with or without lupus nephritis: a systematic review and meta-analysis","volume":"14","author":"Wu","year":"2018","journal-title":"Ther Clin Risk Manag"},{"key":"2022062303401358000_48.5.707.10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejim.2016.04.005","article-title":"Pregnancy in women with systemic lupus erythematosus (SLE)","volume":"32","author":"Moroni","year":"2016","journal-title":"Eur J Intern Med"},{"key":"2022062303401358000_48.5.707.11","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00240110"},{"key":"2022062303401358000_48.5.707.12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/0961203318801746","article-title":"Management of pregnancy in systemic lupus erythematosus: what a GP should know","volume":"27","author":"Jordan","year":"2018","journal-title":"Lupus"},{"key":"2022062303401358000_48.5.707.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-205139"},{"key":"2022062303401358000_48.5.707.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207726"},{"key":"2022062303401358000_48.5.707.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"2022062303401358000_48.5.707.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"2022062303401358000_48.5.707.17","first-page":"288","article-title":"Systemic Lupus Erythematosus Disease Activity Index 2000","volume":"29","author":"Gladman","year":"2002","journal-title":"J Rheumatol"},{"key":"2022062303401358000_48.5.707.18","first-page":"1709","article-title":"Decrease in pregnancy loss rates in patients with systemic lupus erythematosus over a 40-year period","volume":"32","author":"Clark","year":"2005","journal-title":"J Rheumatol"},{"key":"2022062303401358000_48.5.707.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.06.012"},{"key":"2022062303401358000_48.5.707.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.07.010"},{"key":"2022062303401358000_48.5.707.21","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jaut.2018.07.016","article-title":"Safety issues and recommendations for successful pregnancy outcome in systemic lupus erythematosus","volume":"93","author":"Nahal","year":"2018","journal-title":"J Autoimmun"},{"key":"2022062303401358000_48.5.707.22","doi-asserted-by":"crossref","first-page":"e0176457","DOI":"10.1371\/journal.pone.0176457","article-title":"Fetal outcomes and associated factors of adverse outcomes of pregnancy in southern Chinese women with systemic lupus erythematosus","volume":"12","author":"Zhan","year":"2017","journal-title":"PLoS One"},{"key":"2022062303401358000_48.5.707.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.09.066"},{"key":"2022062303401358000_48.5.707.24","first-page":"511","article-title":"Fetal outcome and clinical feature during pregnancy in systemic lupus erythematosus","volume":"65","author":"Shin","year":"2003","journal-title":"Korean J Med"},{"key":"2022062303401358000_48.5.707.25","first-page":"147","article-title":"Clinical course and obstetrical outcomes of 94 pregnancies in Korean patients with systemic lupus erythematosus (SLE)","volume":"51","author":"Ahn","year":"2008","journal-title":"Korean J Obstet Gynecol"},{"key":"2022062303401358000_48.5.707.26","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1111\/1756-185X.12435","article-title":"Pregnancy outcomes in patients with systemic lupus erythematosus: a retrospective review of 62 pregnancies at a single tertiary center in South Korea","volume":"17","author":"Park","year":"2014","journal-title":"Int J Rheum Dis"},{"key":"2022062303401358000_48.5.707.27","doi-asserted-by":"crossref","first-page":"577","DOI":"10.7150\/ijms.8.577","article-title":"Pregnancy outcomes and appropriate timing of pregnancy in 183 pregnancies in Korean patients with SLE","volume":"8","author":"Ko","year":"2011","journal-title":"Int J Med Sci"},{"key":"2022062303401358000_48.5.707.28","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1177\/0961203319877258","article-title":"Pregnancy outcomes in women with rheumatic diseases: a real-world observational study in Japan","volume":"28","author":"Sugawara","year":"2019","journal-title":"Lupus"},{"key":"2022062303401358000_48.5.707.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.012"},{"key":"2022062303401358000_48.5.707.30","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.semarthrit.2020.01.014","article-title":"Maternal and perinatal outcomes of pregnancies in systemic lupus erythematosus: a nationwide population-based study","volume":"50","author":"Chen","year":"2020","journal-title":"Semin Arthritis Rheum"},{"key":"2022062303401358000_48.5.707.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.02.104"},{"key":"2022062303401358000_48.5.707.32","doi-asserted-by":"crossref","first-page":"e0182341","DOI":"10.1371\/journal.pone.0182341","article-title":"Prevalence of abortion and adverse pregnancy outcomes among working women in Korea: a cross-sectional study","volume":"12","author":"Park","year":"2017","journal-title":"PloS One"},{"key":"2022062303401358000_48.5.707.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2017.02.009"},{"key":"2022062303401358000_48.5.707.34","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jri.2017.11.005","article-title":"Factors associated with adverse pregnancy outcomes in women with systematic lupus erythematosus","volume":"125","author":"Deguchi","year":"2018","journal-title":"J Reprod Immunol"},{"key":"2022062303401358000_48.5.707.35","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000194205.95870.86"},{"key":"2022062303401358000_48.5.707.36","doi-asserted-by":"publisher","DOI":"10.1191\/0961203306lu2279rr"},{"key":"2022062303401358000_48.5.707.37","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken458"},{"key":"2022062303401358000_48.5.707.38","doi-asserted-by":"publisher","DOI":"10.1191\/0961203304lu1063oa"},{"key":"2022062303401358000_48.5.707.39","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/art.41191","article-title":"2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases","volume":"72","author":"Sammaritano","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"2022062303401358000_48.5.707.40","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/s41584-018-0133-2","article-title":"New therapeutic strategies in systemic lupus erythematosus management","volume":"15","author":"Gatto","year":"2019","journal-title":"Nat Rev Rheumatol"},{"key":"2022062303401358000_48.5.707.41","doi-asserted-by":"publisher","DOI":"10.1177\/0961203310397967"},{"key":"2022062303401358000_48.5.707.42","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1002\/art.40571","article-title":"Comparison of remission and lupus low disease activity state in damage prevention in a united states systemic lupus erythematosus cohort","volume":"70","author":"Petri","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"2022062303401358000_48.5.707.43","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker410"},{"key":"2022062303401358000_48.5.707.44","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1007\/s40674-018-0085-3","article-title":"Treatment of systemic lupus erythematosus (SLE) in pregnancy","volume":"4","author":"Shirley","year":"2018","journal-title":"Curr Treat Options Rheum"},{"key":"2022062303401358000_48.5.707.45","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1016\/S2665-9913(19)30105-5","article-title":"Factors associated with damage accrual in patients with systemic lupus erythematosus with no clinical or serological disease activity: a multicentre cohort study","volume":"2","author":"Apostolopoulos","year":"2020","journal-title":"Lancet Rheumatol"},{"key":"2022062303401358000_48.5.707.46","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2147\/OARRR.S87828","article-title":"Management of systemic lupus erythematosus during pregnancy: challenges and solutions","volume":"9","author":"Knight","year":"2017","journal-title":"Open Access Rheumatol"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.200802","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T10:42:21Z","timestamp":1655980941000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.200802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,15]]},"references-count":46,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,1]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.3899\/jrheum.200802"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.200802","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,15]]}}}