Abstract: Objective To analyze the outcomes of pregnancies in women with systemic lupus erythematosus (SLE) and the risk factors affecting the outcomes. Methods The data of SLE patients with pregnancy admitted from October, 2006 and September, 2015 were analyzed for assessing the maternal and fetal outcomes and complications. Their risk factors affecting the outcomes of the pregnancies were analyzed. Results The 66 SLE patients (69 pregnancies) had a mean age at SLE diagnosis of 22.9 ± 5.1 years with a mean duration of SLE of 4.1±3.6 years before pregnancy. Forty-five (65.2%) of the patients received oral medication for SLE treatment during pregnancy, and 44 (63.8% ) were treated with prednisone and 19 (27.5% ) were treated with hydroxychloroquine. The highest SLEDAI score was 6.8±7.4 during pregnancy. The patients with moderate-to-severe disease activity had a higher rate of fetal loss (12［54.5%］vs 12［25.5%］) with a significantly lower birth weight of the newborns than those with remittent or mild disease (2073.0± 778.7 vs 2817.8±533.7 g, P<0.05). The patients with moderate-to-severe disease activity also had higher rates of new-onset SLE (9［40.9%］vs 6［12.8%］), hypertension (12［54.5%］vs 3［6.4%］), active lupus nephritis (22［100%］vs 4［8.5%］), pneumonia (5［22.7%］vs 2［4.3%］), and renal insufficiency (8［36.4%］vs 2［4.3%］) compared with patients with remittent and mild disease (P<0.05). Active lupus nephritis (OR=6.10，95%CI: 1.43-25.96) was a significant predictor of adverse outcomes of the pregnancies. Conclusion Fetal loss and maternal complications are common in patients with SLE in relation with the disease activity. Active lupus nephritis is a predictor for poor outcomes of pregnancies in SLE patients.