Pregnancy And Lupus: It's Still Safe To Get Pregnant When Symptoms Aren't Completely Under Control

Statistics from the Lupus Foundation of America estimate that 1.5 million Americans suffer from the autoimmune disease that can chronically damage many parts of the body, with roughly five million affected worldwide. Dealing with lupus during pregnancy can be a particularly daunting topic as the health issue may pose serious complications to the health of the mother and future child.

New findings published in the Annals of Internal Medicine help ease some related concerns for women with lupus who are hoping to have a child. They show that women with the autoimmune disorder whose disease is not very active at the start of their pregnancy are more likely to have a safe pregnancy than once thought, disputing previous studies that told women to wait until symptoms were completely under control.

For the study, researchers identified several risk factors that might put some women with systemic lupus erythematosus (SLE or lupus) at higher risk for bad outcomes during pregnancy, including the following: if their disease was active, the need for high blood pressure medications, low platelet counts and a positive lupus anticoagulant test result during the first trimester.

A multicenter, multiethnic and multiracial study followed 385 pregnant women with lupus between the ages of 18 and 45 enrolled in the Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus (PROMISSE) Trial between September 2003 and December 2012 from eight U.S. sites and one in Canada. All were enrolled during the first trimester of pregnancy.

Researchers found that roughly 81 percent of pregnancies were uncomplicated, with fewer than one in five women experiencing at least one poor pregnancy outcome. Poor pregnancy outcomes included premature birth (9 percent); fetal death during the second or third trimester (4 percent); infant death due to pregnancy complications (1 percent) and very low birth weight (10 percent). Flares of lupus were also very rare and severe flares only occurred in about 3 percent of the participants.

The disease typically begins during the 20s and 30s and is more prevalent in women, according to the American College of Rheumatology. It also tends to be more common in black, Hispanic and Asian individuals, with smptoms including but not limited to extreme fatigue, headaches, painful joints, fever, anemia and/or swelling of the feet, hands legs and eyes.

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