<prompt> Grave prognostic factors of woman with SEE pregnancy includeQuiescent for 6 monthsSerum creatinine 1.4 mgdL24-h urine protein excretion 2.6 gAll of the above  <response>: B Serum creatinine 1.4 mgdL Pregnancy and Lupus: Fertility rates for men and women with SLE are probably normal. However, rate of fetal loss is increased approximately two- to threefold in women with SLE. Fetal demise is higher in mothers with high disease activity, antiphospholipid antibodies, andor nephritis. Suppression of disease activity can be achieved by administration of systemic glucocorticoids. A placental enzyme, 11--dehydrogenase 2, deactivates glucocorticoids; it is more effective in deactivating prednisone and prednisolone than the fluorinated glucocorticoids dexamethasone and betamethasone. Therefore, maternal SLE should be controlled with prednisoneprednisolone at the lowest effective doses for the shortest time required. Adverse effects of prenatal glucocorticoid exposure primarily betamethasone on offspring may include low birth weight, developmental abnormalities in the CNS, and predilection toward adult metabolic syndrome. In SLE patients with aPL on at least two occasions and prior fetal losses, treatment with heparin standard or low-molecular- weight plus low-dose aspirin has been shown in prospective controlled trials to increase significantly the proportion of live births. An additional potential problem for the fetus is the presence of antibodies to Ro, sometimes associated with neonatal lupus consisting of rash and congenital heart block. The latter can be life-threatening; therefore the presence of anti-Ro requires vigilant monitoring of fetal heart rates with prompt intervention delivery if possible if distress occurs. Women with SLE usually tolerate pregnancy without disease flares. However, a small proportion develops severe flares requiring aggressive glucocorticoid therapy or early delivery. Poor maternal outcomes are highest in women with active nephritis or irreversible organ damage in kidneys, brain, or heart. 