Planning a Safe Pregnancy When You Have Lupus

By

Paige Greenfield

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More than 90 percent of people with lupus are women, and most are diagnosed during their childbearing years. Naturally, the questions of whether a woman with lupus can sustain a healthy pregnancy and have a healthy baby often come into play. While complications can arise, the good news is that with the right medical care, you can decrease your risks and deliver a normal, healthy baby.

How Does Lupus Affect Pregnancy?

Women with lupus have a greater risk for miscarriage, premature birth, and other complications compared with most women. Here’s an overview of some of the problems that may occur.

Pre-eclampsia

Approximately 20 percent of women with lupus develop this condition, which occurs when you experience a sudden increase in blood pressure, protein in your urine, or both when you’re pregnant. It needs to be treated immediately and may mean that your baby needs to be delivered right away.

Antiphospholipid antibodies

About 33 percent of women with lupus have these proteins, which can cause blood clots in the placenta and can impact your baby’s growth. With the use of medications, such as a small dose of baby aspirin, your doctor can reduce the risk that you will miscarry even if you have these dangerous antibodies.

Neonatal lupus syndrome

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Although very rare, some women with lupus have an antibody, called anti-Ro, which puts them at risk for delivering a baby with neonatal lupus syndrome. Neonatal lupus is not lupus. Babies born with this syndrome have a skin rash or low blood cell counts, but these symptoms go away over time. Some infants with neonatal lupus are born with a serious heartbeat abnormality. It’s treatable, but permanent. Some babies with the heart problem will grow normally, while others may need a pacemaker.

Steps to Take for a Healthy Mom and Baby

Despite those risks, you can still safely become pregnant and deliver a normal, healthy baby. These steps can help you do just that:

  • Try to conceive when your lupus is in remission. Women who get pregnant when their disease has been in remission for five to six months are less likely to experience a flare during pregnancy than those who conceive while their lupus is still active.

  • Work closely with a perinatologist, a doctor who specializes in high-risk pregnancies. All pregnancies in women with lupus are considered high-risk.

  • Discuss with your doctor which medications to continue taking and which to stop. Many medications used to treat lupus, such as Medrol and aspirin, are safe. Others, like Cytoxan and CellCept, can be harmful to the developing fetus.

  • Plan your delivery at a hospital with a unit that specializes in caring for premature newborns. Twenty-five percent of women with lupus deliver prematurely.

  • Don’t attempt a home delivery or drug-free childbirth. Many complications that can occur during delivery are treatable when in the right setting such as a hospital.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 10, 2017

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