A symposium organised by Weill Cornell Medical College in Qatar (WCMC-Q) has discussed lupus and its impact on women.
One of the world’s foremost experts in the field presented advances in research into pregnancy complications caused by lupus as well as anti-phospholipid syndrome at the university’s latest edition of Grand Rounds.
Visiting speaker Dr Jane Salmon, professor of medicine at Weill Cornell Medical College in New York (WCMC-NY), discussed the discoveries made through her research team’s experiments on mice, which have revealed the underlying mechanisms of poor pregnancy outcomes in women with the chronic autoimmune disorders lupus and anti-phospholipid syndrome.
Lupus, which primarily affects women, is a disorder in which the immune system damages healthy tissues throughout the body, such as the skin and joints, and sometimes the internal organs. The precise cause of this often painful and distressing condition is unknown and there is no cure, although there are some medicines that can control the symptoms.
Anti-phospholipid syndrome is an immune disorder that causes blood clots and is associated with complications in pregnancy. It can occur on its own or in association with other diseases, including lupus. Both conditions can cause serious complications in pregnancy, both to the mother and the unborn child.
Dr Salmon said: “Until recently, the advice for women with lupus was simply not to get pregnant because of the concern the disease could flare and lead to serious problems for the mother and the baby, including pregnancy complications such as placental insufficiency, foetal growth restriction and even complete loss of pregnancy. The guidance was to avoid pregnancy but this recommendation was not based on strong data.”
Dr Salmon also said that pregnant women with lupus had a higher risk of suffering preeclampsia, a condition characterised by high blood pressure that can lead to serious complications.
Dr Salmon led a study that followed 700 patients through pregnancies to identify factors that predicted their outcomes.
She added that better understanding of the disease has led to new advice, which recommends that many patients with lupus can safely carry babies to full term. Pregnancy should be planned carefully when lupus disease is quiescent and in close consultation with an obstetrician and a rheumatologist who specialises in pregnancy care.
In a series of experiments in pregnant mice, Dr. Salmon’s laboratory was able to prove that inflammation, not thrombosis, prevents the normal formation of blood vessels to the placenta, which are required to nourish the developing foetus. The compromised placental development leads to restricted foetal growth, preeclampsia and miscarriage.
Dr Jane Salmon, professor of medicine at WCMC-NY
