LEVELS OF LUPUS AUTOANTIBODIES IN PREGNANT SLE PATIENTS - CORRELATIONS WITH DISEASE-ACTIVITY AND PREGNANCY OUTCOME

Objective: To follow the levels of lupus autoantibodies throughout pre gnancy in a large cohort of pregnant SLE patients, and to examine whet her they correlate with disease activity and pregnancy outcome. Method : 54 pregnancies in 46 SLE patients, and 70 control pregnant women wer e followed in the study. All patients were receiving steroid treatment . Titers of antibodies to ssDNA, dsDNA, histones, cardiolipin (CL) and phosphatidylserine (PS) were determined at the first, second, and thi rd trimester and post-partum by ELISA. Results: Overall the average le vels of autoantibodies in all the patients were within the normal rang e, except for the average levels of anti-dsDNA antibodies which were e levated during the second trimester. Eight women (14.5%) had active di sease during pregnancy, and there was a significant correlation betwee n the levels of anti-dsDNA and the risk of disease activity (p = 0.022 5). There were 7 fetal losses. There was a tendency for correlation be tween elevated anti-dsDNA levels, and anti-CL levels and the risk of f etal loss; however, this did not reach statistical significance (p = 0 .0685, and 0.0881, respectively). There was a significant correlation between the levels of anti-dsDNA antibodies and the risk of preterm de livery (p = 0.0331). Conclusions: Pregnancy in SLE patients is associa ted with significant complications to both the mother and the fetus. A nti-dsDNA levels seem to correlate with the risk of disease exacerbati on, and prematurity. Elevated levels of anti-dsDNA and anti-CL may sug gest an increased risk of fetal loss.