Lupus
Contents of this Article
Pregnancy and Women With Lupus
Women with lupus can safely become pregnant. Babies born to women with lupus have no greater chance of birth defects or mental retardation than do babies born to women without lupus. About 3 in 100 babies born to mothers with lupus will have neonatal lupus. In most cases, this goes away after 3 to 6 months and does not come back.
Although a lupus pregnancy is considered high risk, most women with lupus carry their babies safely to the end of their pregnancy. Women with lupus have a higher rate of miscarriage and premature births compared with the general population. In addition, women who have antiphospholipid antibodies are at a greater risk of miscarriage in the second trimester because of their increased risk of blood clotting in the placenta.
During your pregnancy, your OB will regularly check the baby's heartbeat and growth with ultrasound (a machine that takes pictures of your baby's organs). About 3 in 10 women with lupus will give birth too early. Although this can present a danger to the baby, most problems can be treated in a hospital that specializes in caring for premature newborns - a neonatal (newborn) intensive care unit at the time of delivery in case the baby requires special medical attention.
Breastfeeding
Breastfeeding is possible for mothers with lupus. Some medicines can pass through your breast milk to your infant. Talk to your doctor about whether breastfeeding is safe if you are using any medicines to control your lupus. Breastfeeding also can be very tiring because breastfed babies eat more often than formula-fed babies. If the demands of breastfeeding become too much for you, think about breastfeeding only some of the time. Pumping breast milk to be used later also might help.
How Can I Tell Whether Changes in My Body are Normal or Signs of a Flare?
It may be hard to tell the difference. You may have symptoms from being pregnant that you mistake for a flare. Here are some examples:
- Skin - while pregnant, you may have red palms and a rash. Lupus can also cause a rash.
- Joints - lupus can cause pain and swelling in your joints. Pregnancy can cause aching in your joints.
- Lungs - taking deep breaths can be hard if you have lupus. Pregnancy also can cause shortness of breath.
Fortunately, recent studies show that flares are uncommon and tend to be mild during pregnancy. Some women with lupus find their symptoms improve during pregnancy. Still, it's important to report new symptoms to your doctor. This way, flares that do occur can be prevented or controlled.
Pregnancy and Flares
If your disease is under control, pregnancy is unlikely to cause flares. But there are some important things you should know before you become pregnant:
- Your disease should be under control or in remission for 12 months before you get pregnant. Getting pregnant when your lupus is active could result in miscarriage, stillbirth, or other serious problems. Planning ahead is critical if you have lupus.
- Some women may experience a mild to moderate flare during or after their pregnancy, others do not. The flares happen most often in the first or second trimester or in the first few months after you have the baby. Most flares are mild and easily treated with proper medical care.
- Preeclampsia (pronounced - pree-ee-KLAMP-see-uh) - is hypertension with a buildup of excess watery fluid in cells or tissues of the body. Preeclampsia used to be called toxemia. It is a serious condition that must be treated right away. Preeclampsia is a condition starting after 20 weeks of pregnancy that causes high blood pressure and problems with the kidneys and other organs. About 2 in 10 pregnant women with lupus get preeclampsia. If you get this, you might notice sudden weight gain, swelling of the hands and face, blurred vision, dizziness, or stomach pain. You might have to deliver your infant early.
- Although many women with lupus have normal pregnancies, all lupus pregnancies should be considered "high risk". This means there are certain factors that make problems during pregnancy more likely for women with lupus. It doesn't mean there will be problems.
- Pregnant women with lupus, especially those taking corticosteroids, also are more likely to develop high blood pressure, diabetes, hyperglycemia (high blood sugar), and kidney complications, so regular care and good nutrition during pregnancy are essential.
Planning ahead and proper medical care are very important.
- Find an obstetrician (OB) who manages high-risk pregnancies and who can work closely with your regular doctor.
- Plan to have your baby at a hospital that can manage high-risk patients and provide the special care you and your baby may need.
- See your doctor often while you are pregnant.
- Talk to your doctor about which medicines are safe to use while pregnant.
- Develop a plan for help at home during your pregnancy and after your baby is born. Motherhood can be very tiring, and even more so for women with lupus.
- Develop a birth control plan for after you have your baby. It would be unwise for you to become pregnant again soon after giving birth. It is possible to get pregnant before your period begins again or while you are breastfeeding.
References:
1) The National Women's Health Information Center - U.S. Department of Health and Human Services - Office on Women's Health - May 2008 - www.4woman.gov
2) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) - Information Clearinghouse - National Institutes of Health - Department of Health and Human Services - NIH Publication No. 03-4178 - September 1997 - Revised August 2003 - www.niams.nih.gov
This summary is a general overview about the topic discussed and does not include all the facts, or include everything there is to know about any medicine and/or products mentioned. Do not use any medicine and/or products without first talking to your doctor. Possible side effects of medications, other than those listed, may occur. Full Disclaimer & General Safety Advisory