Abstract Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune multisystem dihe criteria for SLE according to thsease that mainly affects females of childbearing age. SLE still possesses risks during pregnancy that lead to poor maternal and fetal outcomes. The objectives of the study were to identify factors associated with unfavorable pregnancy outcomes and develop a predictive risk score for adverse pregnancy outcomes in patients with SLE. Results: The main predictive factors associated with adverse pregnancy outcomes among lupus patients in multiple linear regression were an absence of remission for at least 6 months before conception, preexisting lupus nephritis, active disease at conception, C3 hypocomplementemia, and antiphospholipid antibody syndrome. Each predictor is assigned a weighted point score, and the sum of points represents the risk score. The area under the receiver operating characteristic curve (ROC) was 0.948 (95% confidence interval, 0.908–0.988), suggesting that the score had strong discriminatory power for adverse pregnancy outcomes. Conclusions: In this study, a predictive model with a risk score classification for adverse pregnancy outcomes in SLE patients was developed. This could help rheumatologists identify high-risk pregnant patients for better disease monitoring and management, resulting in better maternal/fetal outcomes.