Navigation Links
Most women with lupus can have successful pregnancy outcomes
Date:11/5/2011

Promising research led by investigators at Hospital for Special Surgery may offer hope for women with lupus who once thought that pregnancy was too risky.

Results from the multicenter National Institutes of Health (NIH) funded PROMISSE initiative, being presented Monday, Nov. 7 and then during a press conference on Tuesday, Nov. 8, during the American College of Rheumatology's 2011 Annual Scientific Meeting in Chicago, show that most women with stable lupus can have successful pregnancies.

"There was a misconception, based on outdated experience, that women with lupus should not try to have children," said Jane Salmon, M.D., the study's senior author and Collette Kean Research Chair at Hospital for Special Surgery in New York City. "Now that our treatments are more effective and we have a better understanding of the disease, we can identify a window when pregnancy is safe and outcomes are good for mother and fetus."

Historically, women with systemic lupus erythematosus (also know as SLE or lupus) have been advised not to become pregnant because of risks to their own and their fetus' health. SLE is a chronic inflammatory disease, in which the body's own immune system attacks tissues of the body and can cause complications during pregnancy.

Drs. Salmon, together with Jill Buyon from New York University Medical Center, and their collaborators evaluated 333 pregnant women with lupus from the PROMISSE Study (Predictors of pRegnancy Outcome: BioMarkers In antiphospholipid antibody Syndrome and Systemic Lupus Erythematosus), which seeks to identify biomarkers that predict poor pregnancy outcomes. The research team found that 80 percent of lupus patients had a favorable pregnancy outcome.

Patients with lupus may be free of symptoms for long periods of time and then experience a disease "flare," when symptoms such as rash, joint pain, chest pain, swollen legs, bruising and/or fatigue suddenly appear.

"Most women with stable lupus, defined as limited disease activity and no flares during the time of conception and the first trimester, had successful pregnancies," explained Dr. Salmon, who is also the principal investigator of the PROMISSE Study. "We learn from these results that timing is a most important element for successful pregnancy in women with lupus and that avoiding pregnancy during periods of increased disease activity is essential."

In the study, two categories of pregnancy complications were evaluated: the health of the mother and of the fetus. The research team studied development of mild, moderate, or severe increases of lupus activity, or flares, in expectant mothers. For the fetus, the study examined the worst outcome death or situations in which the well being of the child would require extended hospitalization in a critical care unit.

Of the 333 women with lupus studied, 63 had poor outcomes. Ten percent of mothers experienced preeclampsia, a serious complication characterized by the onset of high blood pressure and appearance of protein in the urine. Ten percent experienced mild or moderate flares at 20 weeks and eight percent experienced flares at 32 weeks. Nineteen women experienced death of the fetus and 30 women delivered before 36 weeks or had newborns of small gestational size smaller in size than normal for the baby's sex and gestational age, commonly defined as a weight below the 10th percentile for gestational age.

None of the women in the study was pregnant with more than one fetus, took more than 20 mg/d of prednisone, or had abnormally high excretion of protein or impaired kidney function. The women who experienced complications had more active lupus at 20 and 32 weeks and higher levels of antiphospholipid antibodies.

The PROMISSE study was funded by the National Institute of Arthritis, Musculoskeletal and Skin Diseases of the National Institutes of Health in 2003 to identify biomarkers that would predict poor pregnancy outcomes in lupus patients. To date, the PROMISSE investigative team has enrolled 647 volunteers who are monitored with monthly checkups and research laboratory studies looking at genes and circulating proteins that may predict the course of pregnancy. PROMISSE will continue through 2013 with $12.3 million in support over ten years from NIAMS and the office of Research in Women's Health. Dr. Salmon and co-investigators from 11 academic centers will continue to examine a broad range of genes and molecular pathways that can affect pregnancy in women with lupus, and, it is anticipated that their findings will have applications for the prevention of miscarriage and preeclampsia in healthy women.


'/>"/>

Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1197
Hospital for Special Surgery
Source:Eurekalert

Related medicine news :

1. Pregnancy Safe for Most Women With Lupus: Study
2. Mayo Clinic: Young women with rheumatoid arthritis at more risk for broken bones
3. Online Forums Can Help Women Cope With Pregnancy Loss
4. Obese Women Face Higher Complication Risk After Breast Surgery
5. Wayne State creating computer-based drug intervention for at-risk post-partum women
6. Women No More Likely to Die After Angioplasty
7. Yoga Gets Women With Back Pain Moving: Study
8. Women undergoing PCI display greater number of co-morbidities than men
9. Not All Women at Higher Risk in Families Carrying Breast Cancer Gene
10. Gender differences: Viewing TV coverage of terrorism has more negative effect on women
11. Religious, spiritual support benefits men and women facing chronic illness, MU study finds
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/29/2017)... (PRWEB) , ... March 29, 2017 , ... VisualSP has ... sustainably. Until recently, the only option for on-premises installation of its Help System for ... required to install the system into the entire tenant. , The company recently ...
(Date:3/28/2017)... ... March 28, 2017 , ... India’s Chigurupati Technologies announced ... address the resolution to globally reduce the harmful use of alcohol set forth ... and TTB approved ingredients that when infused into alcohol, renders the alcohol liver ...
(Date:3/28/2017)... ... 29, 2017 , ... The Thyroid Secret is a specialized ... The program was recently launched on March 1, and Dr. Wentz discussed varied ... , Dr. Izabella Wentz is a licensed pharmacist and a foremost thyroid specialist. ...
(Date:3/28/2017)... ... March 28, 2017 , ... ... the science and clinical practice of radiosurgery, announced today the publication of ... observational registry established to standardize data collection from patients treated with stereotactic ...
(Date:3/28/2017)... ... March 28, 2017 , ... WHO: , Dr. Paul Thomas; Dr. ... , Medical doctors and PhD scientists will speak to the press on behalf of ... support of an independent vaccine safety commission. , WHERE: , Zenger Room, National ...
Breaking Medicine News(10 mins):
(Date:3/29/2017)... /PRNewswire/ - Medicure Inc. ("Medicure") (TSXV:MPH, OTC:MCUJF), a specialty ... year ended December 31, 2016 after market close ... being released later than the previous fiscal year,s ... operations and balances of Apicore from the acquisition ... filing date meets TSX Venture Exchange listed company ...
(Date:3/28/2017)... 28, 2017 The global emerging cancer diagnostics ... 13.45% from 2016 to 2023 and reach a figure ... Cancer is a chronic disease and is affecting a ... diagnostics market. This report is focused on emerging cancer ... growth is propelled due to factors such as: increasing ...
(Date:3/28/2017)... SPRING, Md. , March 28, 2017 /PRNewswire-USNewswire/ ... approved Dupixent (dupilumab) injection to treat adults with ... patients whose eczema is not controlled adequately by ... are not advisable. Dupixent can be used with ... of Dupixent demonstrates our commitment to approving new ...
Breaking Medicine Technology: