Pregnancy in systemic lupus erythematosus (SLE) patients is associated with an increased risk of adverse outcomes. During pregnancy, SLE patients have a higher rate of miscarriage, stillbirth, preterm delivery, fetal growth restriction, or hypertensive disorders of pregnancy. To date, only a few case–control studies were published with the purpose to evaluate the magnitude of risk associated with pregnancy in lupus patients. The aim of our study was to evaluate the maternal and fetal outcomes in a cohort of Portuguese SLE patients and to compare it with a group of healthy pregnant women. We conducted a retrospective case–control study that included all pregnant women with SLE managed at a Portuguese tertiary center, between 2010 and 2019. Pregnancy outcomes were compared between SLE patients and a group of matched healthy pregnant women. Baseline maternal data was collected, and maternal–fetal and neonatal outcomes were evaluated. One hundred twenty-four SLE pregnancies were included. Of the patients, 95.2% were in remission at conception. In 13.7% of cases, a lupus flare was diagnosed during gestation and in 17.9% in the postpartum period. The live birth rate was 84.6%, and the incidence of adverse outcomes was 40.3% (OR 2.64, 95% CI 1.67–4.18). Considering only patients in remission at conception, the presence of adverse outcomes remained significantly higher (36.8% vs. 20.3%, P < 0.01). Miscarriage rate was 15.3% (OR 5.85, 95% CI 2.57–13.34) and preterm delivery occurred in 12.4% of the patients (OR 1.72, 95% CI 0.83–3.57). Preeclampsia prevalence was higher in SLE patients (OR 3.92, 95% CI 1.32–11.57). In the SLE group, the newborn admission to an intensive care unit rate was increased (OR 4.99, 95% CI 1.47–16.90). No neonatal or maternal deaths were reported. In our study, pregnancy with SLE was associated with an increased incidence of adverse outcomes, even in a population of SLE patients with well-controlled disease.

系统性红斑狼疮 (SLE) 患者的妊娠与不良结局风险增加有关。在怀孕期间，SLE 患者流产、死产、早产、胎儿生长受限或妊娠期高血压疾病的发生率较高。迄今为止，仅发表了少数病例对照研究，目的是评估狼疮患者与妊娠相关的风险程度。我们研究的目的是评估一组葡萄牙 SLE 患者的母体和胎儿结局，并将其与一组健康孕妇进行比较。我们进行了一项回顾性病例对照研究，纳入了 2010 年至 2019 年间在葡萄牙三级中心管理的所有 SLE 孕妇。比较了 SLE 患者和一组匹配的健康孕妇的妊娠结局。收集基线母体数据，并评估母胎和新生儿结局。包括 124 例 SLE 妊娠。在这些患者中，95.2% 的患者在受孕时处于缓解状态。在 13.7% 的病例中，在妊娠期间诊断出狼疮发作，在产后诊断为 17.9%。活产率为84.6%，不良结局发生率为40.3%（OR 2.64，95% CI 1.67-4.18）。仅考虑受孕时缓解的患者，不良结局的存在仍然显着增加（36.8% vs. 20.3%，活产率为84.6%，不良结局发生率为40.3%（OR 2.64，95% CI 1.67-4.18）。仅考虑受孕时缓解的患者，不良结局的存在仍然显着增加（36.8% vs. 20.3%，活产率为84.6%，不良结局发生率为40.3%（OR 2.64，95% CI 1.67-4.18）。仅考虑受孕时缓解的患者，不良结局的存在仍然显着增加（36.8% vs. 20.3%，P  < 0.01)。流产率为 15.3%（OR 5.85，95% CI 2.57-13.34），12.4% 的患者发生早产（OR 1.72，95% CI 0.83-3.57）。SLE 患者的先兆子痫患病率较高（OR 3.92，95% CI 1.32–11.57）。在 SLE 组中，新生儿入住重症监护病房的比率有所增加（OR 4.99，95% CI 1.47–16.90）。没有报告新生儿或孕产妇死亡。在我们的研究中，SLE 妊娠与不良结局的发生率增加相关，即使在疾病控制良好的 SLE 患者群体中也是如此。