Risks for Pregnant Women With Lupus
Large Study Details Complications From C-Sections to Death
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.
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
- 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
- More likely to have low blood platelet counts and anemia during delivery,
which may contribute to their threefold increased need for transfusion during
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
"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