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Year : 2020  |  Volume : 12  |  Issue : 2  |  Page : 141

Maternal and fetal outcomes in patients with systemic lupus erythematosus

Department of Pediatrics and Child Health, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission01-Jun-2020
Date of Decision02-Jun-2020
Date of Acceptance02-Jun-2020
Date of Web Publication27-Jun-2020

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P. O. Box: 55302, Baghdad Post Office, Baghdad
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmbs.ijmbs_60_20

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How to cite this article:
Al-Mendalawi MD. Maternal and fetal outcomes in patients with systemic lupus erythematosus. Ibnosina J Med Biomed Sci 2020;12:141

How to cite this URL:
Al-Mendalawi MD. Maternal and fetal outcomes in patients with systemic lupus erythematosus. Ibnosina J Med Biomed Sci [serial online] 2020 [cited 2022 Aug 16];12:141. Available from: http://www.ijmbs.org/text.asp?2020/12/2/141/288205

Dear Editor,

In January-March 2020 issue of the Ibnosina Journal of Medicine and Biomedical Sciences, Ahmed et al.[1] reported that preexisting hypertension and secondary antiphospholipid syndrome were correlated with an increased risk of pregnancy complications in Libyan pregnant women with systemic lupus erythematosus (SLE).[1]

There are a few notable methodological limitations that ought to be considered. In the study methodology, Ahmed et al.[1] established that the diagnosis of SLE was based on fulfilling at least four of the 1997 American College of Rheumatology (ACR) criteria.[2] It is worth mentioning that the 1997 ACR criteria have numerous limitations, namely equal weighting of features that differ in the clinical relevance, bias toward longer duration and more severe disease, and exclusion of SLE patients from research that do not fulfill the four criteria.[3] Hence, a good number of pregnant women with SLE who did not meet the four criteria of the 1997 ACR criteria were expected to be misdiagnosed and could not be enrolled in the study.[1] This might consequently seriously influence the study results.

A newer classification criteria for SLE supported jointly by the European League Against Rheumatism and ACR have been proposed utilizing strict methodology with a multidisciplinary input. The newer classification criteria have both higher sensitivity (96.1%) and specificity (93.4%) in comparison with 82.8% sensitivity and 93.4% specificity of the 1997 ACR criteria.[4] Consequently, employing the newer diagnostic SLE criteria could have been better in elucidating the adverse outcomes and their likely predictors in SLE pregnant women.

Authors' contributions

Single author.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Ahmed AM, Ibkhatra SA, Elbraky FM, Alsaeiti KD. Maternal and fetal outcomes in patients with systemic lupus erythematosus. Ibnosina J Med Biomed Sci 2020;12:33-7.  Back to cited text no. 1
  [Full text]  
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.  Back to cited text no. 2
Smith EL, Shmerling RH. The American College of Rheumatology criteria for the classification of systemic lupus erythematosus: Strengths, weaknesses, and opportunities for improvement. Lupus 1999;8:586-95.  Back to cited text no. 3
Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol 2019;71:1400-12.  Back to cited text no. 4


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