Placental lesions in systemic lupus erythematosus pregnancies associated with small for gestational age infants.
Increased perivillous fibrin deposition more common in SLE placentas with small for gestational age infants
Placental lesions in systemic lupus erythematosus pregnancies associated with small for gestational age infants.
Up to a quarter of pregnant individuals with SLE have small for gestational age (small for gestational age) infants.
We aimed to characterize placental pathology associated with small for gestational age infants in SLE.
We retrospectively analysed SLE deliveries with placental analysis at UCSD from November 2018 to October 2023, comparing SLE pregnancies resulting in small for gestational age to those that did not, and additionally, to matched pregnancies with small for gestational age but without SLE.
Placental analysis was available only for 28/70 (40%) SLE deliveries, which had high rates of adverse outcomes (75%).
All exhibited at least one histopathologic abnormality.
All seven SLE placentas with increased PVFD resulted in small for gestational age infants.
The higher prevalence of increased PVFD in placentas of SLE-associated small for gestational age may indicate a specific mechanism of placental injury leading to small for gestational age in this context.
Thus, its presence, particularly in context of small for gestational age, should prompt providers to screen for an underlying autoimmune disease, including SLE.
Systematic placental examination in context of SLE and associated autoimmune diseases could help evaluate responses to existing therapies, comparative studies of novel therapies and correlation to adverse outcomes.