SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana KaplanUpdate on pregnancy complications in systemic lupus erythematosusMarder, Wendya,bAuthor Information aDivision of Rheumatology, Department of Internal Medicine bDepartment of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, USA Correspondence to Wendy Marder, MD, MS, Department of Obstetrics & Gynecology, Michigan Medicine, North Campus Research Complex, B014 G236, 2800 Plymouth Rd, SPC 2800, Ann Arbor, MI 48109-2800, USA. Tel: +1 734 936 1166; fax: +1 734 763 1253; e-mail: [email protected] Current Opinion in Rheumatology: November 2019 - Volume 31 - Issue 6 - p 650-658 doi: 10.1097/BOR.0000000000000651 Buy Metrics Abstract Purpose of review This review summarizes recent research in the field of systemic lupus erythematosus (SLE) and pregnancy with focus on clinical and biochemical predictors of adverse pregnancy outcomes (APOs), accumulating evidence for the safety and efficacy of hydroxychloroquine (HCQ) in pregnancy, and the importance of preconception counseling. Recent findings Ongoing research from PROMISSE investigators (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) adds to the understanding of risk factors for APOs in SLE pregnancies, including aberrant complement activation, incomplete downregulation of lupus-associated transcription factors, and lower socioeconomic status. Evidence supporting numerous advantages for continuing HCQ in pregnancy, as well as support for low-dose aspirin in preeclampsia prevention is reviewed. Practice gaps exist among rheumatologists in ensuring effective contraception when women of childbearing age are undergoing therapy with potentially fetotoxic medications. The publication of organizational guidelines provides evidence-based recommendations on lupus pregnancy management. Summary Outcomes of lupus pregnancies continue to improve with understanding of risk factors that predict APOs as well as improvements in disease management. Rheumatologists caring for women with SLE should be familiar with the most up-to-date research in order to optimize pregnancy outcomes in this population. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.