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because of increased risk of blood clots in the placenta or umbilical cord [80-84]. Lupus
patients with a history of kidney disease have a higher risk of pre-eclampsia. Pregnancy
counseling and planning before pregnancy are important for lupus patients. Ideally, a woman
should have no signs or symptoms of lupus and be taking no medications for at least 6 months
before she becomes pregnant.
Some women may experience a mild to moderate flare during or after their pregnancy;
others do not. Pregnant women with lupus, especially those taking corticosteroids, also are
more likely to develop high blood pressure, diabetes, hyperglycemia and renal complications;
thus, regular prenatal care and good nutrition during pregnancy are essential. It is also
advisable to have access to a neonatal intensive care unit at the time of delivery, in case the
baby requires special medical attention [80-84]. For women with lupus who do not wish to
become pregnant or who are taking drugs that could be harmful to an unborn baby, reliable
birth control is important. Previously, oral contraceptives were not an option for women with
lupus because doctors feared the hormones in the pill would cause a flare of the disease [85].
However, a large NIH-supported study termed Safety of Estrogens in Lupus Erythematosus
National Assessment (SELENA) found that severe flares were no more common among
women with lupus taking oral contraceptives than those taking a placebo (inactive pill). As a
result of this study published in 2005, physicians are increasingly prescribing oral
contraceptives to women with inactive or stable lupus [85].

Current Research in Lupus

Lupus is the focus of intense research, as scientists try to determine precisely what causes
the disease and how it can best be treated. Some of the central research questions include: 1)
Why are women more likely than men to have the disease? 2) Why are there more cases of
lupus in selected racial and ethnic groups, and why are cases in these groups often more
severe than in Caucasian patients? 3) What specific derangements occur in the immune
system, and why do they occur? 4) How can we therapeutically correct the way the immune
system functions? 5) What treatment approaches will work best to ameliorate lupus
symptoms? 6) How can we cure lupus?. To help address these questions, scientists are
developing new and improved ways to study the disease. They are performing laboratory
studies that compare aspects of the immune systems of lupus patients with those of healthy
people. They also utilize mouse models with disorders resembling lupus, to better understand
the abnormalities of the immune system that occur in lupus and to identify possible new
therapies. In the US, the National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS) within the U.S. Department of Health and Human Services National Institutes of
U.S. or applicable copyright law.

Health (NIH), funds many lupus researchers. A tissue bank collection from children affected
by neonatal lupus and their mothers is also available.

Genetics in Lupus
Identifying genes that 1) play a role in the development of lupus, or 2) affect lupus
severity is an active area of research. NIAMS intramural and extramural investigators have

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