Lupus and Rheumatoid Arthritis
FACT: 75 percent of all autoimmune disorders, such as lupus, occur in women, most often during their childbearing years.
Autoimmune disorders like lupus and rheumatoid arthritis (RA) seem to primarily afflict women; in fact, some 75 percent of these conditions -- in which the body mistakenly attacks healthy tissue -- occur in women, and most often in their childbearing years, according to the American Autoimmune Related Diseases Association.
If you have lupus, the most common symptoms -- joint pain, fever, rashes, chest pain, and shortness of breath -- are likely to worsen while you're expecting, says Megan E.B. Clowse, MD, an assistant professor of rheumatology and immunology at Duke University Medical Center, in Durham, North Carolina. "Because lupus affects the joints, blood pressure, kidneys, and brain, it tends to cause more general problems than Rheumatoid Arthritis (RA), which essentially affects the joints."
To keep flare-ups at bay, you'll need to make a monthly trip to your rheumatologist to ensure that any signs of lupus are quickly controlled. Even when your lupus is well in hand, the condition can still increase your risk for preeclampsia (or pregnancy-induced hypertension), perhaps due to the fact that prednisone, often taken to control inflammation, can raise blood pressure. A 2006 study in Arthritis & Rheumatism found that the risk for hypertension was three times higher in women with lupus.
When it comes to rheumatoid arthritis, which usually causes pain in the joints, especially in the wrists and hands, pregnancy offers an upside. "About 75 percent of women with RA will improve during pregnancy,? says Dr. Clowse. In fact, you may even be able to stop your medication while pregnant." However, there's also some not-so-good news for RA sufferers: 25 percent will have a preterm birth, you're more likely to have a smaller baby, and the majority of patients who got a reprieve from symptoms while expecting will have what Dr. Clowse calls "a significant recurrence within the six months following delivery."
With either condition, make an appointment to see your rheumatologist within a month of arriving home from the hospital. "To ward off a big flare-up, which can happen with both RA and lupus, you want to get back as soon as possible on any medications that were stopped for the pregnancy," says Dr. Clowse.
But no matter what your condition, take heart in knowing that if you actively manage it over those nine months, you're apt to have a happy outcome.