--Excerpted from Arthritis and Rheumatism, 2006; 54:899-907

The good news is that relatively large numbers of women with rheumatic conditions do choose to bear children, and the majority appear to have good pregnancy outcomes. The bad news is that women with some rheumatic diseases, e.g., lupus, rheumatoid arthritis, and antiphospholipid antibody syndrome, face an increased risk of pregnancy complications and, thus, should undergo careful antenatal monitoring in order to minimize any adverse consequences. This was the conclusion reached through a study done by Dr. Eliza F. Chakravarty, of Stanford University School of Medicine in Palo Alto, California, and her colleagues.

Dr. Chakravarty and her team studied data from the 2002 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project to compare rates of pregnancy complications among women with lupus, antiphospholipid antibody syndrome, rheumatoid arthritis, pre-gestational diabetes mellitus, and the general population. The sample consisted of roughly 4 million births. This included 24,427 by women with pre-gestational diabetes; 3,264, with lupus; 2,884, with antiphospholipid antibody syndrome; and 1,425 women with rheumatoid arthritis.

The study showed the following: In the general population, the researchers found that hypertensive disorders occurred in 7.8 percent of pregnancies, and 26.5 percent were Caesarean births. In women with lupus, hypertensive disorders occurred in 23.2 percent of the women; and 39.4 percent had Caesarean births. Furthermore, in the lupus patients, intrauterine growth retardation occurred more than three times than for women in the control group. The odds ratio of hypertensive complications in women with antiphospholipid antibody syndrome was 1.6, and 3.4 in women with intrauterine growth retardation. Among rheumatoid arthritis patients, rates of hypertensive complications, premature rupture of membranes, and intrauterine growth retardation were slightly but significantly higher than for control patients.

It was reported that, while patients with lupus, antiphospholipid antibody syndrome, and/or rheumatoid arthritis were older than the control group, their increased risk of complications remained after the researchers controlled for age and other relative factors. --Excerpted from Arthritis and Rheumatism, 2006; 54:899-907