Saudi Journal of Kidney Diseases and Transplantation

REVIEW ARTICLE
Year
: 2020  |  Volume : 31  |  Issue : 1  |  Page : 10--20

Pregnancy and lupus nephritis in developing countries: A systematic review


Sukriti Bansal1, Ogochukwu Okoye2, Nilum Rajora3 
1 Michael E. DeBakey Department of Surgery, Baylor College of Surgery, Houston; University of Texas Southwestern Medical Center, Dallas, Texas, USA
2 Department of Internal Medicine, Faculty of Heath Sciences, Delta State University, Abraka, Nigeria
3 Nephrology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA

Correspondence Address:
Nilum Rajora
Department of Internal Medicine, Nephrology Division, University of Texas Southwestern Medical Center, Dallas, Texas
USA

Systemic lupus erythematosus (SLE) and lupus nephritis (LN) have a significant impact on the course of pregnancy, as well as on maternal and fetal outcomes. LN in pregnancy can increase the maternal risks of SLE flare, acute kidney injury, preeclampsia, and even death. It also affects fetal outcomes by the increased risk of intrauterine growth retardation, premature delivery, and fetal loss. Successful pregnancy outcomes have been well documented in the developed world, but less is known about patients in developing nations. We searched PubMed and Google scholar for all articles published from 1999 to 2016 in developing countries. Twelve of 13 studies were included excluding only one. All studies were independently reviewed. Most of the studies reported a significant association between high flare rates of LN and higher rates of disease flare. Higher rates of active disease at conception were associated with lower live birth rates. Similarly, high flare rates of LN were associated with higher rates of fetal loss. With regard to geographic trends, Indian studies reported lower overall live birth rates and higher rates of active disease at conception. Interestingly, lower rates of preeclampsia were also noted in Indian studies. Higher rates of flare were observed in other Asian studies, but not the Indian studies. Although LN and active SLE at conception are associated with poor fetal outcomes, better outcomes are possible with proper management, even in low-resource settings. More research is necessary to fully understand the relationships between active disease at conception or LN and flare rates, live birth rates, and fetal loss rates in developing countries.


How to cite this article:
Bansal S, Okoye O, Rajora N. Pregnancy and lupus nephritis in developing countries: A systematic review.Saudi J Kidney Dis Transpl 2020;31:10-20


How to cite this URL:
Bansal S, Okoye O, Rajora N. Pregnancy and lupus nephritis in developing countries: A systematic review. Saudi J Kidney Dis Transpl [serial online] 2020 [cited 2020 Mar 29 ];31:10-20
Available from: http://www.sjkdt.org/article.asp?issn=1319-2442;year=2020;volume=31;issue=1;spage=10;epage=20;aulast=Bansal;type=0