Systemic lupus erythematosus

Rheumatic diseases predominantly affect young women of childbearing age; therefore pregnancy is a topic of major interest. Pregnancy-induced changes in immune function can have an effect on underlying disease activity.[1-3] Pregnant women with rheumatic diseases constitute a high-risk population, with potential adverse fetal and maternal outcomes. Treatment options can be limited in pregnant women owing to concerns about the adverse effects of commonly used medication on the fetus.[4] Systemic lupus erythematosus (SLE) is a multisystem disease and the most prevalent autoimmune disease affecting women during their reproductive years, with an incidence of 1/1 000 women.[5] Women with SLE have normal fertility but may have complicated pregnancies.[6] Prior exposure to cyclophosphamide is the main risk factor for infertility,[5,6] and is related to dosing and age of the patient, with exposure for patients older than 35 years carrying a higher ris