All are true about SLE in pregnancy except?
**Core Concept**
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs and is known to have a complex relationship with pregnancy. Pregnancy can be both a risk factor for SLE flares and a potential trigger for disease activity.
**Why the Correct Answer is Right**
Increased levels of anti-Ro and anti-La antibodies are actually associated with an **increased risk** of congenital heart block in newborns of mothers with SLE. This is because these antibodies can cross the placenta and affect the fetal heart, leading to congenital heart block. Therefore, the statement that increased anti-Ro and La implies low risk for congenital heart block is incorrect.
**Why Each Wrong Option is Incorrect**
**Option B:** Steroids are a crucial part of SLE management and can be continued in pregnancy, but their use requires careful monitoring due to potential side effects on the fetus.
**Option C:** Recurrent abortions are indeed a complication associated with SLE, particularly due to antiphospholipid antibodies and lupus anticoagulant.
**Option D:** Disease activity can indeed worsen during pregnancy, particularly in the first trimester and postpartum period.
**Clinical Pearl / High-Yield Fact**
It's essential for clinicians to be aware of the potential risks of SLE in pregnancy, including congenital heart block, fetal growth restriction, and preeclampsia. Regular monitoring of disease activity and fetal well-being is crucial to ensure optimal outcomes.
**β Correct Answer: A. Increased anti Ro and La implies low risk for congenital heart block**