Lupus and Pregnancy - Stability is key

I thought this article from Medscape News was pretty interesting - seems like I'm a perfect example of how successful a lupus pregnancy (or two!) can be, if and when your disease activity is stable. There was a time when I was told I shouldn't get pregnant, then a time when I couldn't get pregnant. Later on, once I'd come to embrace the disease, rather than fight so hard against, I decided that I wouldn't get pregnant - for the sake of my own health, as well as the prospect of a little life inside of me. But then fast forward a few years, and the time was right. I was healthy, I was strong, and my lupus was stable - a perfect setup for two perfect pregnancies. I'm not saying it's a guarantee for smooth sailing...but it sure does help, as the article indicates.

Most importantly, I found that preparation was key. I worked far in advanced with all of my doctors to ensure that I had the best chance for healthy pregnancies. Consult your rheumatologist, and find a good high-risk obstetrician BEFORE you plan on becoming pregnant. Deirdre and Bernie would agree - it's the only way to go!

Here are the snippets I like from the article - but you can read the entire article here:

 Women with stable lupus erythematosus have a far lower rate of serious complications during pregnancy than previously reported, even those with a history of lupus nephritis, according to data presented here at the American College of Rheumatology 2011 Annual Meeting.

The "extraordinary news," said first author and presenter Jill Buyon, MD, from New York University Medical Center, in New York City, is that just 15 patients (4%) had a severe flare during their pregnancy, and just 18% experienced a mild to moderate flare, most of which resolved without steroids.

Risk factors associated with poor outcome include slightly higher baseline disease activity (measured by clinical instruments and physician global assessment), the presence of lupus anticoagulant antibodies, slightly higher uric acid in the second and third trimesters, and a smaller complement increase as the pregnancy progresses.

"What the study says is that even patients with a history of lupus nephritis can do well during pregnancy," she said, assuming they become pregnant when their disease is stable and they are managed by maternal–fetal medicine specialists who specialize in high-risk pregnancies. "That's a really encouraging message to give these women."

associate professor of medicine at Emory University School of Medicine in Atlanta, Georgia, said most rheumatologists are "nervous" and "scared" about women with lupus becoming pregnant.

"I think this study is vitally needed," said [S. Sam Kim, MD] . "It gives us some more reassurance and direction. Any guidance we can have in terms of reproductive issues is extremely important in the field of lupus and the people we treat."