Lupus Pregnancy

While most women with lupus do well during pregnancy, giving birth to full-term babies with no complications, it's best to be in remission for at least six months prior.

Disease flares during pregnancy, even if they are more frequent during pregnancy, usually are mild.

But there are some risks with lupus pregnancies, including premature birth and fast-developing high blood pressure (pre-eclampsia), so careful monitoring is key.

Two LRI researchers in particular are looking at aspects of lupus pregnancy:

LRI researcher Robert A. S. Roubey, MD at the University of North Carolina at Chapel Hill is looking at the link between the presence of antiphospholipid antibodies, blood clots, and complications such as stroke and miscarriage. Antiphospholipid antibodies interfere with the normal function of blood vessels.

With LRI funding, he has set out to develop new tests to predict which lupus patients with antiphospholipid autoantibodies are at increased risk for developing clots. He's on the hunt for markers of this clotting risk, to determine who might benefit from potentially life-saving treatment, such as blood thinners, to prevent clots from forming.

"If we can prove that certain people are at much greater risk of blood clots, the next thing to do would be to figure out the best way to treat them before a blood clot occurs," Dr. Roubey said. "The new test may open up that realm."

LRI Researcher Robert Winchester at Columbia University in New York City is pursuing a highly innovative concept that preeclampsia in lupus is caused by a dramatically reduced number of cells that normally encourages growth of the placenta by recognizing the foreign antigens of the fetus.

Preeclampsia, in which very high blood pressure develops and protein spills out into the urine, endangering the health of mother and child, occurs in approximately 1 in 10 pregnancies among women with lupus.

Robert Winchester, MD
Columbia University College of Physicians and Surgeons, New York, NY
Class of 2011