Which of the following conditions is especially concerning during pregnancy in women with SLE?

Preterm birth is particularly concerning for women with systemic lupus erythematosus (SLE) during pregnancy due to the complex interplay between the disease and pregnancy-related physiological changes. Women with SLE are at an increased risk for various pregnancy complications, and preterm birth can occur as a result of disease activity, which may be exacerbated by the inflammatory processes associated with SLE. Additionally, SLE can affect placental function, leading to issues like impaired blood flow, which may result in preterm labor.

Furthermore, preterm birth can have significant implications for neonatal health, including increased risks of respiratory distress syndrome, developmental delays, and other complications associated with being born before full term. Thus, monitoring and managing the risk of preterm birth is crucial in pregnant women with SLE to ensure both maternal and fetal well-being.

While gestational diabetes, placenta previa, and fetal abnormalities can certainly be concerns during pregnancy, the evidence strongly indicates that preterm birth is a more direct consequence of SLE's impact on pregnancy outcomes. This prioritization reflects the specific risks tied to autoimmune activity and its effects on gestation in the context of SLE.