Pregnancy Safe for Women with Stable Lupus

Women with lupus have been warned about becoming pregnant in the past, but new research posits that those with mild or moderate disease activity can carry a baby safely.

Researchers examined 385 pregnant women with systemic lupus erythematosus (SLE), none of whom had high disease activity at the start of the study.

Adverse pregnancy outcomes were defined as fetal or neonatal death, very low birth weight, or birth before 36 weeks because of placental insufficiency, hypertension, or preeclampsia.

Fetal death occurred in only 4% of pregnancies, neonatal death in 1%, preterm birth in 9%, and very low birth weight in 10%. The majority of pregnancies (81%) did not involve any adverse outcomes.

In addition, severe maternal flares occurred in only 2.5% of second trimesters and 3% of third trimesters.

“One of the questions I’m most commonly asked by young women with lupus is whether it is safe to get pregnant,” said lead study author Jill. P. Buyon, MD, director of the division of rheumatology and the Lupus Center at the NYU Langone Medical Center, in a press 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. For patients who may be facing a complicated pregnancy, we have been able to pin down some of the risk factors.”

Predictors of adverse pregnancy outcomes included antihypertensive medication use, low platelet counts, positive lupus anticoagulant test result, maternal flares, and higher disease activity.

For women who did not have these baseline risk factors, the odds of an adverse pregnancy outcome were only 7.8%.

“In pregnant patients with inactive or stable mild or moderate SLE, severe flares are infrequent, and absent specific risk factors, outcomes are favorable,” the researchers concluded.

Although there is no cure for lupus, some studies have shown that omega-3 fish oils may have a therapeutic effect in those with mild SLE activity.

The current study was published in the Annals of Internal Medicine.