Aggravation (or exacerbation) of lupus has been estimated to occur in about 20-30% pregnancies where the mother has lupus.[1] Increased disease activity of lupus is expected during pregnancy because of increased levels of estrogen, prolactin, and certain cytokines.[2] However, a long time of remission before pregnancy decreases the risk of aggravation,[10] with an incidence of 7-33% in women who have been in remission for at least 6 months, and an incidence of 61-67% in women who have active lupus at the time of conception.[2]