Lupus & Pregnancy Article Review

By Dr. Robert Katz

A research paper in the journal Lupus entitled, “The Importance of Pregnancy Planning in Lupus Pregnancies,” Rajendran, Euty, and other authors from Duke University Medical Center studied lupus pregnancy outcomes in those with planned pregnancies compared to those with unplanned pregnancies.

The average age of the lupus women was 29.4 years, and 60 percent were planned pregnancies and 40 percent were not planned. Patients with unplanned pregnancies did not do as well, had more severe adverse pregnancy outcomes, and more severe infant outcomes than those with planned pregnancies.

Women with not planned pregnancies were more likely to conceive when lupus activity was higher, less likely to receive pre-pregnancy counseling with a rheumatologist, and less likely to continue pregnancy-compatible medications.

Generally, we have found that lupus patients who have well-controlled, inactive disease do okay with pregnancy, whereas women with active lupus disease are at much higher risk for pregnancy and neonatal complications. It is important to control lupus activity before women get pregnant and to give them advice and close follow up during pregnancy. With effective pregnancy planning and contraception guidance, we should be able to decrease the risk for mother and fetus, reducing the chance of medical problems and adverse outcomes of pregnancy.

Robert S. Katz, M.D.