1 3 Rheumatol Int DOI 10.1007/s00296-016-3525-0 Rheumatology INTERNATIONAL WOMEN ISSUES Pregnancy outcomes in women with childhood-onset and adult-onset systemic lupus erythematosus: a comparative study Miguel Ángel Saavedra 1 · Dafhne Miranda-Hernández 1 · Antonio Sánchez 1 · Sara Morales 2 · Pilar Cruz-Domínguez 3 · Gabriela Medina 4 · Luis Javier Jara 5 Received: 13 March 2016 / Accepted: 28 June 2016 © Springer-Verlag Berlin Heidelberg 2016 and fetal complications was similar in both groups. Multi- variate analysis showed that active SLE before pregnancy, primigravida, renal flare, preeclampsia, lupus flare, anti- cardiolipin antibodies, and low serum complement were associated with an increased risk of poor maternal and fetal outcomes. The diagnosis of childhood-onset had no impact on maternal–fetal outcome. The maternal and fetal outcome in women with childhood-onset SLE is similar to that reported in women with adult-onset SLE. Pregnancy in women with childhood-onset SLE should not be contrain- dicated if the disease is well controlled. Keywords Pregnancy · Maternal–fetal outcome · Systemic lupus erythematosus · Childhood-onset lupus Introduction Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that predominantly affects women in reproductive age, and up to 20 % of the cases begin dur- ing adolescence or before [1]. Although the clinical pres- entation and laboratory abnormalities of childhood-onset SLE are similar to SLE starting in adulthood, it is consid- ered that childhood-onset SLE has a more aggressive clini- cal course with an increased frequency of organic disease, higher SLEDAI scores, and increased use of immunosup- pressive and increased mortality compared to its counter- part starting in adulthood [2, 3]. Several studies have examined maternal/fetal outcome in women with SLE, where they found a greater number of complications compared with healthy pregnant women. [4]. However, information from pregnant patients with childhood-onset SLE is more limited. In a report of 24 unplanned pregnancies in 23 women studied in a Brazilian Abstract To compare the maternal and fetal outcomes between childhood-onset and adult-onset systemic lupus erythematosus (SLE), we reviewed the medical records of SLE pregnant women treated from January 2005 to August 2013. For comparison, patients were allocated to one of the two groups, those pregnant patients with SLE onset before 18 years of age (childhood-onset) and ≥18 years (adult-onset). The patients were evaluated at least once in each trimester and postpartum. Relevant maternal and fetal outcomes were extracted, such as lupus flare, preeclampsia/ eclampsia, rate of liveborns, fetal loss (spontaneous abor- tion and stillbirth), term delivery, preterm birth, neona- tal death, low birth weight, low birth weight at term, and congenital malformations. We studied 186 pregnancies (in 180 women), 58 of them had childhood-onset SLE, and the remaining 128 had adult-onset SLE. The rate of maternal * Miguel Ángel Saavedra miansaavsa@gmail.com 1 Rheumatology Department, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico 2 Perinatology Department, Hospital de Gineco-Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico 3 Division of Investigation, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico 4 Clinical Research Unit, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico 5 Direction of Education and Research, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico