Most women with lupus can have good pregnancy outcomes – new findings
One of the greatest concerns in women with lupus is if it is safe to become pregnant and now a new 10-year study has shown that most women can expect a good pregnancy outcome if their lupus is inactive and they are free of certain risk factors.
Systemic lupus erythematosus mainly affects women of childbearing age. It is an autoimmune disease in which the body’s immune system attacks and damages healthy tissue. It can affect the skin, joints, kidneys, brain and other organs. In the past, women with lupus were advised not to become pregnant because of potential risks to their health and that of their baby.
So experts followed 385 pregnant from the US and Canada in the largest ever prospective study of lupus pregnancies. All women were enrolled in the first 12 weeks of their pregnancies and had inactive or stable mild-to-moderate lupus disease activity at the time of enrolment. They were seen by study investigators every month and the results published in the Annals of Internal Medicine.
Results
• 81% of pregnancies were free of complications;
• Foetal or neonatal death occurred in 5% of pregnancies;
• 9% of women had a preterm delivery;
• 10% of babies had a low birth weight.
But most women with these complications had at least one risk factor such as: a specific antiphospholipid antibody in the blood; a history of high blood pressure; or a low platelet count.
“Our findings provide a clear direction for counseling patients, and reassuring women with inactive lupus,” says Dr Jane Salmon, lead author. “We also learned that patients with specific clinical features and certain antibodies that can be detected early in pregnancy by blood tests have an increased risk of serious pregnancy complications.
“It was exciting to see that severe lupus flares occurred in less than 3% of women during pregnancy. Lupus patients and their doctors can be confident of a good pregnancy outcome in most cases if lupus is quiescent when they become pregnant. Our findings now allow clinicians to identify the patients at high risk and manage them accordingly.”
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Image credit: Jens Bergander
