Lupus is an autoimmune disease which occurs when the body’s immune system attacks its own tissues and organs. Lupus and pregnancy aren’t connected in any way; It does not affect your fertility or your ability to get pregnant. In fact, less than 50% of women with lupus suffer complications in their pregnancy. However, doctors consider all lupus pregnancies high-risk. This means that women with lupus run a higher risk of facing complications during their pregnancy. Lupus may result in complications such as miscarriage, pre-term delivery, poor pre and postnatal health, and even have an effect on the baby, such as causing heart problems. Therefore, lupus pregnancies are considered high risk, both for the mother and the baby.

However, there are steps you can take to make your pregnancy a safe one. It is not impossible to become a mother if you have lupus.

Steps to take to make your pregnancy safe

Before you get pregnant, consult your doctor. Consult an expert who specializes in lupus and complications that arise from it. When you plan to get pregnant, it is advisable that you meet a doctor who specializes in high-risk pregnancies: a high-risk obstetrician. You need to have a proper assessment of how your lupus has affected you so far and how it might end up affecting you if you get pregnant. You have to be aware of all the risks you are taking.

Lupus affects all patients differently. Not all lupus pregnancies are the same, therefore, you need to be as informed about your condition as possible, so you can be prepared for potential dangers during the pregnancy. Your doctor might suggest treatments early on in the pregnancy to combat complications that might arise as the result of your lupus. It is therefore very important to work in close consultation with your doctor.

Alter and adapt your medication to go with your pregnancy. It should be designed to protect your pregnancy and the baby. Some lupus medication will not aid your pregnancy and might even have an adverse effect on it. Therefore, you need to be sure you’re taking the right kind of medication so that your baby stays safe. For example, Hydroxychloroquine (Plaquenil) and prednisone are considered safe to use during pregnancy. Methotrexate and cyclophosphamide (Cytoxan) should not be taken while pregnant and should be discontinued for at least a month before getting pregnant.

Lupus and Pregnancy: Things You Need to Know

Before pregnancy

Unplanned pregnancies aren’t always very easy to deal with, but if you are a lupus patient, unplanned pregnancies can be downright dangerous for you. It isn’t easy to plan a pregnancy since so many things could go wrong, but you should always plan it thoroughly with your partner before going through with it. Pregnancy in lupus is high-risk and therefore should be avoided at all costs unless you have gone through a careful examination and are aware of the risk you are taking. Unplanned pregnancies can be potentially fatal to lupus patients.

After you get pregnant

Once you do get pregnant, get very regular prenatal checkups. This seems like a very general advice for pregnant women, but it is especially more important for a woman with lupus to get regular health checkups for both her and her baby’s health. If there are any complications arising, regular checkups will help detect them early on so that treatment can be commenced immediately. About 25% of lupus pregnancies may result in premature birth of the infant. And between 20% and 30% of women with lupus will experience preeclampsia. This is a sudden increase in blood pressure and protein in the urine, which leads to swelling in body tissue. Preeclampsia often requires urgent treatment and can only be cured by delivery of the baby; therefore seeing your doctor often is of the utmost importance.

Potential Risks

Fatigue

Fatigue is one of the most common side effects of lupus. And pregnancy, when added to it, can be overly exhaustive. Even when a woman isn’t suffering from lupus, pregnancy can be extremely tiring. It is therefore important that when you have lupus, you take it easy during pregnancy. You need to get as much rest as you can. Avoid doing activities that are physically demanding. It is also important that you don’t gain unnecessary weight during pregnancy and follow a nutritious, healthy diet. Make sure that you get regular exercise and enough rest for your body to recover. In fact, many women report an actual improvement in lupus symptoms during pregnancy. Women don’t experience lupus flares as much during pregnancy as they would have before getting pregnant. It is, therefore, necessary that you take extra care of yourself while you are pregnant.

Hypertension

Hypertension is a real threat for lupus patients. Additionally, about 30% of pregnant women who have lupus are susceptible to hypertensive complications during pregnancy. Having a high blood pressure can also increase the possibility of preeclampsia during pregnancy. Preeclampsia occurs in one out of about five lupus pregnancies. It is a serious condition and requires immediate medical attention and delivery of the baby. Preeclampsia is more common in women who have lupus induced liver issues and women who smoke. If you suffer from any of these, you should consult a high-risk obstetrician before and during your pregnancy.

Premature delivery

One in three lupus pregnancies ends with a premature delivery. Premature or preterm delivery is when the baby is delivered before completing 37 weeks of pregnancy. You should therefore be prepared for a premature delivery, because it will always be a possibility in a lupus pregnancy. Signs that you are going into premature labour include a backache, contractions, abdominal cramps, pelvic pressure and blood or fluid leakage from the vagina. See a doctor immediately if you face any of these symptoms. Choose a hospital that specializes in infant care and offers a neonatal intensive care unit. Though prematurity does present risks to the baby, most issues can be properly treated in a hospital that specializes in infant care.

If you are lupus patient, you are always at risk of developing complications during your pregnancy. It is important that you visit your doctor and specialist while you are contemplating conceiving, and be very prepared and careful during pregnancy. While it is possible that you might develop complications during pregnancy, lupus does not affect the chances of deformity or defects in your baby.

References:

https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745

https://resources.lupus.org/entry/planning-a-pregnancy