Background: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that predominately affects women (90%) during their childbearing years. Pregnancy complications in women with SLE exceed that of the general population. Women with systemic lupus erythematosus (SLE) have fewer children on average than other women. This research aimed to analyse the perspectives of individuals with SLE in Ireland towards pregnancy. The research involved 23 semi-structured interviews with participants from Lupus groups in Ireland using multiple case study analysis. Two key findings emerged in the qualitative interviews: reluctance towards becoming pregnant, and not conceiving again post-diagnosis. This paper through analysis of qualitative findings highlights the need for psychosocial education and awareness in the clinical management of SLE and pregnancy. Patient counselling should be available for all possible issues that may arise both for the individual with SLE (risk of disease flares and pregnancy complications) and the foetus (risk of neonatal lupus syndromes and learning difficulties). There is a necessity for education on optimal disease control with safe medications during pregnancy. Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that predominately affects women (90%) during their child-bearing years. When an individual has SLE although fertility rates are similar to the general population, fertility rates can be affected by renal failure and high steroid dosage  Pregnancy can both trigger and cause SLE flares. There is a two-to-three-fold increase in SLE disease activity during pregnancy. Common symptoms of flares include rashes, arthritis, and fatigue, and can often be easily treated. Fatigue is reported by 80% of individuals with SLE independent of pregnancy. Approximately 15-30% of women with SLE, who flare will have severe disease manifestations, with the involvement of the kidneys and other internal organs. Certain complications during pregnancy have a higher frequency in those with SLE than those who do not have lupus including; pre-gestational diabetes mellitus, hypertension, pulmonary hypertension, renal failure, thrombophilia, stroke, pulmonary embolus, deep vein thrombosis, major infections, bleeding and thrombocytopenia. American statistics have shown that during pregnancy pre-eclampsia occurred in 22.5% of women with SLE as against 7.6% in the general population. However, although there are risk factors associated with pregnancy and SLE (disease flares, miscarriage, the safety of drugs), there is now better disease control, pre-pregnancy counselling, and understanding.

With Regards,
Sara Giselle
Associate Managing Director 
Journal of Critical Care Obsestrics & Gynocology