Lupus and Pregnancy

Many women with lupus worry about becoming pregnant. Is pregnancy safe for me? Will I get a lupus flare? Are complications likely? And, most important, will the baby be OK?

Such women will be glad to know that a study recently published in the Annals of Internal Medicine indicates that, in contrast to long-held beliefs, women with lupus can definitely have a successful pregnancy.

The study followed 385 women with lupus during their pregnancies and when the baby was born. The women were from various locations and from different racial and ethnic groups. Not all the women had trouble-free pregnancies, but more than 8 out of 10 of them did. Early birth and small size were two of the difficulties — 9% of the babies were premature and about 10% had a low birth weight, but it must be remembered that about 10% of all babies born in the United States are premature. About 4% of the mothers lost their babies in the second or third trimester.

The mothers who experienced problems during pregnancy were those who were sicker at the start. The researchers identified four factors that appeared to contribute to pregnancy complications in mothers with lupus. The first three were high blood pressure, greater lupus activity during pregnancy, and a low platelet count. The fourth, and highest, risk factor was what is known as lupus anticoagulant. The presence of lupus anticoagulants prevents blood clotting, and the researchers strongly advised that doctors test for it in pregnant women with lupus.

The researchers also found that black, Hispanic, and Asian women tended to have higher rates of complications. They said, however, that these were probably not due to socioeconomic factors because the women were treated by similar doctors in large hospitals that provide specialized care. Instead, they speculated that genetic factors might be involved, something that needs to be investigated.

Perhaps the most encouraging finding, according to the researchers, was the relative lack of kidney trouble. Only four of the women developed kidney disease during pregnancy, and the ones who already had kidney disease when their pregnancies began had “very few” kidney flares.

Want to learn more about managing lupus? Read “Women With Lupus Can Fight Smart” and “How Moms Learn to Live With Lupus.”

Joseph Gustaitis is a freelance writer and editor based in the Chicago area.

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