Lupus and Pregnancy

I’ve always known I’ve wanted children.  It’s never been a question in my mind, I just knew it would be somewhere in my future.  However, once I learned of my lupus diagnosis I had a lot of questions about whether it would be even be possible.

At my last rheumatologist appointment, he gave me the okay to start trying to conceive.  I had been doing some reading, but also needed many questions answered.  I’d like to share what I learned with you!

If you have ANY type of auto-immune issues, you MUST talk with your physician and please use this information as only that… information and not advice or medical orders.

All the changes that come with pregnancy have a huge impact on someone with lupus or other auto-immune issues and so it is very important to discuss with your physician (or team of physicians) when it is safe for you to try and become pregnant. Possible health issues you may have to deal with or treat first?  Hypertension, antiphospholipid antibodies, low platelets, blood clots, kidney or blood sugar issues.  The general rule of thumb is to wait until you have been healthy for at least six months before trying to conceive, this will give you the best chances of having a flare-free pregnancy.

All lupus pregnancies are considered high-risk, and therefore you will be referred to a high-risk obstetrician and a perinatologist (basically a physician specifically for the baby during your pregnancy).  You will also probably need to see your rheumatologist more often.

You have a great responsibility to yourself and your unborn child to pay even more attention to what your body tells you than you normally do.  Normal pregnancies can leave a gal with fatigue and a host of other issues (nausea, body aches, etc) but lupus can add even more difficulties.  Get plenty of sleep and rest.  Eat healthful foods.  Try to keep moving, but don’t over-exert yourself if you are in pain or too tired.  And of course, please don’t smoke, do drugs, drink alcohol, and try to limit your caffeine intake.

What are some possible issues you may face?

• Lupus flares
• Miscarriage
• Stillbirth
• Preeclampsia
• HELLP Syndrome
• Impaired kidney function
• Intrauterine growth restriction
• Neonatal lupus in your infant – About 3% of babies born to Lupies will have this.  Most often it will go away, normally when the baby is 6-8 months old.  It usually consists of abnormal blood counts and a rash, but in rare cases the baby may have an abnormal heart rhythm that will require surgery to implant a pacemaker.
• Preterm delivery – about 50% of pregnancies in Lupies will result in preterm delivery because of lupus complications.

Some women see improvement in their lupus symptoms during pregnancy.  And while flares are reported in about 30% of Lupies, most of them are mild. There are some medications used to treat lupus that cause minimal harm to your baby during pregnancy as they do not cross the placenta.  If you do encounter difficulties, your physicians may discuss some of these possibilities with you. Healthy pregnancies are possible with lupus, it may just take a little more work to get that baby safely in your arms!

Once you have your baby it is just as important to make sure you take great care of yourself.  The changes in hormones and the stress of caring for a newborn are a lot for any new mother, let alone a new mother with lupus.  Rest, healthy eating, and asking for help if you need it are very important.

Hope this may have answered some of your questions about pregnancy and lupus! And while we don’t have any news to report yet, hopefully we will soon!