The Effects of Pregnancy on Systemic Lupus Erythematosus
The safety of pregancy for the woman with systemic lupus erythematosus (SLE) has long been studied. Controversy exists about the occurrence of exacerbations during pregnancy and the effect these exacerbations will have on the basic disease process. The purpose of this study was to investigate the effect pregnancy would have in precipitating exacerbation of disease activity. The investigation was carried out by comparing two matched groups of women with SLE, one group pregnant and the other group nonpregnant. The difference in occurrence of exacerbation among the three trimesters of pregnancy and the pre-pregnancy, pregnancy, and postpartum periods was also studied. This nonexperimental descriptive case study used medical records of six pregnant (the study group) and six nonpregnant (the control group) women with SLE. The criteria for the sample selection was designed to eliminate as many extraneous variables as possible. All patients who met the sample criteria for the study group were included in the study. The records were then surveyed for all who met the criteria for the control group. The control group was then matched to the study group according to grade of disease activity; presence or absence of corticosteroid administration; age, plus or minus five years. Each medical record was reviewed for demographic data, past and present history of disease activity, and medications being taken. When the six pregnant women with SLE were compared with the six nonpregnant SLE women, the occurrence of exacerbations was higher in the nonpregnant group. This may point to the fact that pregnancy does not always precipitate an exacerbation of disease activity. But because of the limitations of uncontrolled variables, sample size, difficulty in matching disease activity and length of time since original diagnosis, and imbalance in length of hospital records, generalization of this finding is impossible. From the eight pregnancies reported, during pregnancy the only two exacerbations occurred during the third trimester, within six weeks of delivery. It was also found that of the pre-pregnancy, pregnancy, and postpartum periods, two exacerbations occurred during postpartum, two during pregnancy, and none during pre-pregnancy. These data suggest that if pregnancy were undertaken by the women with SLE the risk of exacerbation might be greatest during the third trimester and postpartum. The sample size of the present study, however, is too small to make such a generalization.
Nursing, Pregnancy Complications; Lupus Erythematosus; Systemic
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