Access: Lupus Research -- Pregnancy & Reproductive Issues
Research Summaries from 2012
Second Pregnancy Outcomes in Lupus
It is well known that women with lupus are at increased risk of pregnancy-related complications. However, second pregnancy outcomes in women with lupus have not been thoroughly studied. The researchers hoped to learn about second pregnancy outcomes in women with lupus, particularly in those whose first pregnancy had an adverse outcome. The results suggest that second pregnancies in lupus patients have good outcomes, with 90% having a live-born second infant. Therefore, women with lupus whose first pregnancy had an adverse outcome can have reasonable expectations of a live birth in their second pregnancy.
Reproductive Behavior Among Women with Lupus
Women with chronic illnesses such as lupus may have fewer children than they want due to a number of concerns related to having lupus. These concerns include disease-related disability, damage from medications, and potential transmission of disease to offspring. A more detailed understanding of the reproductive behavior of women with lupus can help identify their needs in terms of caring for their disease and become educated about its possible effects, including those on reproduction. The results of this study highlight the reproductive behavior of women with lupus, as compared to those with rheumatoid arthritis, and suggest the need for them to communicate with their physicians about the use of medications considered safe for them and their potential offspring.
Lupus Anticoagulant Affects Pregnancy Outcomes
Having antibodies typical of anti-phospholipid syndrome (APS) can increase the risk of pregnancy complications. However, whether or not specific women with APS, such as women who also have lupus, may be at even greater risk of pregnancy complications has not been fully established or agreed upon. Identification of specific women with APS or specific characteristics, such as the presence of specific APS antibodies, which can predict increased risk of adverse pregnancy outcomes, could be very useful. The results of this study highlight the important role of lupus anticoagulant, as well as that of a previous blood clot, in adverse pregnancy outcomes.
Research Summaries from 2011
Contraceptive Counseling and Use Among Women With Lupus
Lupus is most common in women of reproductive age and, therefore, issues surrounding pregnancy and contraception are of importance to most lupus patients. Since it is best to plan pregnancy when lupus is adequately controlled, it is important that women with lupus have access to adequate methods of contraception. This study examined the value of contraceptive counseling for women with lupus. The researchers also hoped to learn whether contraceptive counseling had effects on the frequency of use of contraceptives among women with lupus.
Research Summaries from 2010
Pregnancy Outcomes in Women with Lupus Nephritis
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Research Summaries from 2009
Factors That Influence Pregnancy Outcomes in Women with Lupus
Although women with lupus used to be advised to avoid getting pregnant, out of fear of complications for the mother, the baby, or both, a better understanding of the complications of lupus and improved management of lupus pregnancies have resulted in improved outcomes; today at least 85 percent of lupus pregnancies result in live births. However, doctors still advise women who have active lupus kidney disease (lupus nephritis, or LN) not to get pregnant until their disease has been inactive for at least six months.
Research Summaries from 2008
Preeclampsia is a condition that may occur during pregnancy, with a four-fold increased risk in lupus patients. It is characterized by high blood pressure and large losses of protein in the urine. This is dangerous for both the mother and the baby. There is no good way to stop preeclampsia other than delivering the baby as soon as possible, and no guaranteed way to prevent it, so women at high risk have to be monitored closely in the last trimester of pregnancy. Risk factors for preeclampsia include prior kidney disease and chronic hypertension.
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Improving Outcomes of Lupus Pregnancies
Although most women with lupus will have successful pregnancies, serious complications can occur in some cases, perhaps none more devastating than the loss of the baby. In fact, some women with lupus have consecutive miscarriages, a condition known as recurrent spontaneous abortion (RSA). Immunglobulins (Ig) are antibody proteins that circulate in the blood. Intravenous immunoglobulin infusion (IVIg) is a medical treatment in which immunoglobulin is administered intravenously. It has been approved as a treatment for several autoimmune diseases, and has been used as a treatment for lupus, as well as for high-risk pregnancies.
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Is Hormone Replacement Therapy During Menopause Safe for Women with Lupus?
Data from two very large studies -- the HERS trial (for Heart and Estrogen/Progestin Replacement Study) and the Women’s Health Initiative -- have raised questions about the use of hormone replacement therapy (HRT) for women during menopause; those studies seemed to show that HRT increases a woman’s risk for heart disease. This is of even greater concern for women with lupus, because lupus puts women at higher risk for heart disease.
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Research Summaries from 2007
As Teenage Girls with Lupus Mature
Women with lupus may have problems with their menstrual cycle. Early menopause is often the result of treatments for lupus, in particular cyclophosphamide (CYC). This study wanted to see if adolescent females with juvenile lupus were also at risk for these kinds of problems. This research study confirms some earlier studies which suggest that cyclophosphamide is less likely to put younger patients into menopause than older women.
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Medication use and infertility in men with lupus
Because lupus can affect almost every organ system in the body, men who develop lupus may have concerns about their fertility, especially since the presence of antisperm antibodies has been observed in a significant percentage of lupus patients. The researchers sought to determine the frequency and possible causes of sperm damage in men with lupus. The researchers found a high frequency of sperm abnormalities in men with lupus, including lower sperm counts and reduced sperm mobility. Both of these conditions are linked to male infertility.
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