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Risks for Pregnant Women With Lupus

Large Study Details Complications From C-Sections to Death
By
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 14, 2006 (Washington) -- Pregnant women who have lupus are at greater risk for serious complications -- including infection and death, according to the largest study ever to look at pregnancy outcomes in lupus patients.

However, this sounds far worse than it is, experts tell WebMD. Such complications still occur infrequently.

Most women with lupus will have healthy pregnancies and babies.

The new research was presented Tuesday at the 2006 annual meeting of the American College of Rheumatology in Washington, D.C.

Among its findings: Pregnant women with lupus are 20 times more likely to die, and they're four times as apt to develop eclampsia, a serious condition often accompanied by seizures.

"Women with lupus need to be followed very carefully by a rheumatologist and a high-risk obstetrician, but the majority if women with lupus can -- and will -- have a successful pregnancy and deliver a healthy baby," says researcher Megan Clowse, MD.

"I definitely don't think we should prevent lupus patients from getting pregnant because the majority of women who have lupus and become pregnant will do well throughout their pregnancy," says Clowse, who is an assistant professor in the division of rheumatology & immunology at Duke University Medical Center in Durham, N.C.

An autoimmune disease, lupus can affect the skin, joints, kidneys, lungs, nervous system, and other organs. It's 10 times more common in women than men and typically strikes women in their prime childbearing years.

The study used a national database to compare risks faced by pregnant women with and without lupus. Researchers examined the records of the more than 17,000 women with lupus who gave birth during 2000 to 2002.

The Risks

Compared with pregnant women without lupus, women with the disease were:

  • 20 times more likely to die
  • 2.6 times more likely to require a cesarean section
  • Three times more likely to develop preeclampsia, a pregnancy-related condition marked by high blood pressure
  • Four times as likely to develop eclampsia, the most severe phase of preeclampsia and often accompanied by seizures
  • More likely to have co-existing disease including diabetes, kidney failure, and hypertension, any of which can make carrying a baby very difficult
  • More likely to experience a blood clot, stroke, or develop a life-threatening infection
  • More likely to have low blood platelet counts and anemia during delivery, which may contribute to their threefold increased need for transfusion during pregnancy.

John J. Cush, MD, chief of rheumatology and clinical immunology at Presbyterian Hospital of Dallas in Texas, tells WebMD that women with lupus who want to have children should not panic.

"As a disease largely of young women, I am not surprised that pregnancy and pregnancy-related problems are often seen in this population," he says.

"Patients who have lupus need to be careful about their pregnancies -- plan for them and have the right people involved in their care, and they can have healthy pregnancies and babies," he says. "The new findings do not so much sound an alarm as they point to red flags for us to be aware of."

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