Background:

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which a serious complication is lupus nephritis (LN). In the case of pregnant women with LN, an increased risk of maternal-fetal complications is identified.

Purpose:

To determine the frequency and risk of major maternal and perinatal outcomes in pregnant women with LN in Latin America and the Caribbean.

Methodology:

Systematic review of the period 2003-2023 in MEDLINE (Pubmed), EMBASE, LILACS, Web of Science and SCOPUS databases. Selection, extraction, and quality assessment were performed in a paired fashion. The random effects method was used to assess outcomes in meta-analyses. Protocol registered in PROSPERO CRD42023464651.

Results:

12 studies from seven countries were included, mainly retrospective cohorts and one cross-sectional study. Significant associations were identified between the presence of LN vs no LN for the outcomes of perinatal mortality (OR 2.53 [95 % CI 1.23-5.19]) and preeclampsia (OR 2.24 [95 % CI 1.433.49]), but not significant for preterm delivery and miscarriage. Only one death was identified for maternal mortality. There were no findings implicating intrauterine growth restriction (IUGR) or renal failure. In terms of quality assessment, one low quality and 11 high quality articles were presented.

Conclusions:

The high frequency of perinatal mortality and preeclampsia stands out. Although no significant associations were found with maternal mortality, preterm delivery and spontaneous abortion, nor data for IUGR or renal failure. Further research is needed to establish associations between NL and maternal and perinatal outcomes.

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