Pregnancy and Lupus: A Fairly Safe Combination?

Pregnant lupus patients may not face as many dangers as once thought

/ Author:  / Reviewed by: Beth Bolt, RPh

(RxWiki News) Many women with lupus have been warned about the possible dangers of becoming pregnant and having the condition. But new evidence suggests that these risks might have been overestimated.

A new study found that most pregnant women with mild or moderate lupus did not experience any serious health events during pregnancy.

"One of the questions I'm most commonly asked by young women with lupus is whether it is safe to get pregnant," explained lead author Jill. P. Buyon, MD, of the NYU Langone Medical Center, in a news release. "Our new study is quite reassuring in that in the majority of cases, both mother and baby can do well if lupus is under control at conception."

Dr. Rebecca Robert, MD, a board-certified obstetrician-gynecologist at Baylor Regional Medical Center at Grapevine, who was not involved with this study, still encourages women with lupus to pursue prenatal care.

"In general, any woman with a chronic medical condition such as Lupus, who is considering conception should have a preconception consultation with her obstetrician, as a chronic medical illness can put the pregnancy at higher risk for conditions such as preterm labor, growth abnormalities, placental disease, preeclampsia and stillbirth," Dr. Robert told dailyRx News.

Dr. Buyon and colleagues looked at 385 pregnant women with lupus, a condition that is caused by the immune system attacking the body's own tissues.

Lupus can affect different parts of the body, including the joints, skin, kidneys, brain and heart, and can vary in severity and symptoms. Many patients experience "flares" of the condition, or periods of time where the symptoms get worse.

The women entered the study during their first trimester at different sites across the US and Canada. These patients were between the ages of 18 and 45. The study took place between the years 2003 and 2012.

Dr. Buyon and team followed the pregnant women to look for adverse pregnancy outcomes, or health events that occurred while pregnant. These included death of the baby, premature birth and high blood pressure in the mother.

Overall, adverse pregnancy outcomes occurred in only 19 percent of the cases, meaning that 81 percent of the mothers with lupus carried out their pregnancy with no serious issues, Dr. Buyon and team found.

Severe lupus flares were rare as pregnancy progressed. During the second trimester of their pregnancy, only 2.5 percent of the study patients experienced a flare, Dr. Buyon and colleagues found. Only 3 percent did so during their third trimester.

"For patients who may be facing a complicated pregnancy, we have been able to pin down some of the risk factors," Dr. Buyon said.

These risk factors included showing signs of an active lupus flare, having high blood pressure and being on blood pressure medication.

Of the patients who had none of the identified risk factors at the study's start, only 7.8 percent experienced an adverse pregnancy outcome.

This study focused on women with mild or moderate lupus, and further research is needed to better understand the risks of pregnancy for lupus patients.

Dr. Robert added, "Overall, active disease during conception is a strong predictor of adverse outcome. The consultation is to assess risk and minimize disease activity. Current medications should be reviewed for fetal safety, and the patient should be counseled on risk a pregnancy might have on her own health and also risk to the fetus."

Women with lupus should discuss pregnancy and potential risks with their doctor.

This study was published online June 22 in the Annals of Internal Medicine.

A number of groups funded this research, such as the National Institutes of Health and the Mary Kirkland Center for Lupus Research. Several study authors received additional grants from these groups.

Reviewed by: 
Review Date: 
June 22, 2015
Last Updated:
June 25, 2015