Pregnancy in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmnune disease that predomina ntly affects women of reproductive age. Pregnancy and its outcome is a majo r concern to most SLE patients. Queries regarding the risk of disease flare s during pregnancy, chance of fetal loss, and the safety of various drugs a re often raised. With the improvement in the understanding of the pathogene sis of SLE and the judicious use of immunosuppressive drugs, better disease control can now be achieved and SLE patients should not be deprived of the opportunity for bearing children. Prepregnancy counselling and close colla boration with other specialists such as the obstetricians and the perinatol ogists is essential in optimising the maternal and fetal outcome in lupus p regnancies. In this review, important issues regarding the fertility rate, optimal timing of conception, risk of disease flares during lupus pregnancy , pregnancy course, fetal outcome, safety of various drugs used for disease control during pregnancy and lactation, and contraceptive advice are discu ssed.