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Most data about determinants of pregnancy outcomes in women with lupus come from retrospective studies. Now, in this prospective study, 385 pregnant women with lupus were followed with measurement of multiple analytes throughout pregnancy to determine risk factors for adverse outcomes (fetal or neonatal death; birth before 36 weeks' gestation because of placental insufficiency, hypertension, or preeclampsia; and birth weight <5th percentile). Women were excluded if at baseline they had serum creatinine >1.2 mg/dL, prednisone use >20 mg daily, and urinary protein–creatinine ratio >1000 mg/gm.
Adverse fetal or neonatal outcomes occurred in 19% of pregnancies and fetal or neonatal death occurred in 5%. The most important predictors of adverse p…