Vicki Crough of Ridley Park, Pa., always knew she wanted a family, and she also knew that, even before getting pregnant, there would be a lot of things to consider. She made sure she was at a healthy weight and began a sensible exercise plan. She started taking additional vitamins, including folic acid. She made sure she had enough money saved to finance a long maternity leave, and she thoroughly discussed her decision with her husband, Dan, who was happily in agreement.

Yes, Crough did all the things that a woman should do before conceiving a child. But in her case, that wasn't enough. Crough had one other thing to consider – lupus.

"Although I tried to put it in the back of my mind, I knew I couldn't pretend my condition didn't exist," says Crough, who was diagnosed with the chronic disease lupus seven years ago. "I knew that lupus would be a consideration in my pregnancy, labor and delivery," she says.

According to the Lupus Foundation of America (www.lupus.org), lupus is a chronic, autoimmune disease where, for unknown reasons, the immune system becomes hyperactive and attacks normal tissue. These attacks, or flares, result in inflammation and the appearance of a variety of symptoms including rashes, fever, fatigue and achy joints.

Unfortunately, 90 percent of those affected by lupus are women, and the disease is most frequently diagnosed in young women – women who, like Crough, are interested in having children. "It was important to me to have a family, but just as important to know what I'd be up against," Crough says.

Planning ahead is the first good step toward a successful pregnancy for anyone, but especially for women with lupus or other chronic diseases. According to Dr. Stanford Peng, contributing physician-scientist for Veritas Medicine (www.veritasmedicine.com) and a Harvard research associate, studies document flare rates of 25 percent or lower during pregnancy and live birth rates of 95 percent or higher, not significantly different from that of the general population. "Importantly, though, the women in these studies most often undertook 'planned pregnancies,'" says Dr. Peng. "Their disease was in remission at the time of conception."

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