Good pregnancy outcomes in lupus nephritis patients with complete renal remission.

BACKGROUND To investigate pregnancy outcomes and risk factors in patients with lupus nephritis (LN). METHODS A total of 158 pregnancies in 155 women with LN were divided into a remission group and a control group according to whether they achieved complete renal remission (CRR) prior to pregnancy. The adverse pregnancy outcomes and risk factors were retrospectively analyzed. RESULTS In the remission group, 130 LN patients with 133 pregnancies (two twin pregnancies) delivered 127 live births; 25 LN patients with 25 pregnancies delivered 19 live births in the control group. Compared with the control group, the remission group had significantly lower incidence of LN relapse, fetal loss, and premature birth. For LN patients in the remission group, a CRR duration  30 years was an independent risk factor for preeclampsia and premature birth. CONCLUSION LN patients with a complete renal remission duration greater than 18 months were associated with good pregnancy outcomes and lower LN relapse. Age, anti-C1q and anti-phospholipid antibodies, and prednisone dosage during pregnancy were risk factors for adverse pregnancy outcomes.