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Systemic lupus erythematosus is a chronic autoimmune disease that mainly affects women of childbearing age, posing significant challenges during pregnancy due to its complex interaction with gestation. Pregnancy in these patients is considered high-risk due to maternal immune status, and the medications used to treat the disease, which may increase the incidence of obstetric and perinatal complications. Proper family planning and specialized prenatal care are key to minimizing risks and ensuring optimal outcomes. Evaluation of risk factors that may exacerbate the disease or its complications is crucial for preconception counseling. In this context, our review will focus on detailing prenatal care in pregnant patients with systemic lupus erythematosus, identifying best clinical practices, and guiding future research in this field to improve maternal and neonatal outcomes in this population.