Women with systemic lupus erythematosus (SLE) deal with plenty of challenges in their day-to-day lives. Pregnant women with lupus face even more difficulties.
Their risk for preeclampsia is double that of pregnant women who don't have an autoimmune condition.
Preeclampsia is a condition that can occur during pregnancy which involves protein in the urine and high blood pressure after 20 weeks of pregnancy. It can result in organ failure, seizure, stroke and even death for either mother or child, or both.
Women with preeclampsia may not feel any different due to the condition. But they also may have more edema, or swelling, in their face, eyes and hands than is normal during pregnancy. They may find themselves putting on weight quickly in a short time.
If preeclampsia is severe, symptoms can become more varied and more intense.
A woman with preeclampsia may have unrelenting headaches. They may have pain in the belly below their ribs. Their output of urine may decrease, and they may experience nausea or vomiting.
Their eyes may be affected by blurry vision, light sensitivity. They may see spots or flashing lights, or even experience temporary blindness.
Research from the Harvard School of Public Health, led by Kristin Palmsten studied the effects of Disease-Modifying Antirheumatic Drugs (DMARDs) on pregnant women with autoimmune disease including lupus.
The research involved nearly 225,000 women and almost 307,000 pregnancies in British Columbia, Canada between 1997 and 2006. Women were evaluated during their first 20 weeks of gestation, when implantation occurs and the placenta is growing.
DMARDs include: methotrexate (Rheumatrex, Trexall), anti-malarial drugs such as hydroxycholorquine (Plaquenil), and biologics such as etanercept (Enbrel) or adalimumab (Humira).
Most pregnant women with lupus don't use DMARDs, possibly from concern that DMARDs are unsafe during pregnancy, or that their use can increase the risk for preeclampsia. The more severe the sufferer's condition, the greater the risk for preeclampsia.
But women who stopped taking their DMARDs during pregnancy had only a slightly lower risk for preeclampsia than those who continued taking them. Though the recent study did not show statistically significant results to prove that DMARDS decreased the risk of preclampsia, researchers feel that there may still be a benefit in taking them.
Lupus flares pose a risk during pregnancy.Continuing use of DMARDs may be worth considering to reduce or prevent flares.
This research was published in a journal of the American College of Rheumatology, Arthritis Care & Research.
The study and researchers were funded by the National Institutes of Health and the Agency lfor Healthcare Research and Quality. Authors of the study were paid by several companies, some of them Abbott, AstraZeneca, GlaxoSmithKline, Lilly and Novartis.
Women with lupus have a higher risk for preeclampsia. Eurekalert.org. Retrieved Nov. 6, 2012.
Preeclampsia. NCBI.NLM.NIH.gov. Retrieved Nov. 6, 2012.
Lupus May Be Linked to Serious Pregnancy Complication. USNews.com. Retrieved Nov. 6, 2012.
Autoimmune Disease Tied to Preeclampsia. Medpagetoday.com. Retrieved Nov. 6, 2012.
Reviewed November 7, 2012
by Michele Blacksberg RN