Lupus and Pregnancy: Risks and Management
Lupus is an autoimmune disease that mainly strikes women during their childbearing years. For many women living with the disease, that means pregnancy will become an issue at some point in their lives.
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A few decades ago, women with lupus were discouraged from having a family, but now that’s not the case. Most women living with the condition can have successful pregnancies but will need extra attention.
According to the John Hopkins Lupus Center, one of the main risks for women with lupus who wish to start a family is miscarriage. Around 10 percent of lupus pregnancies end in miscarriage, though it’s generally unknown if a miscarriage is lupus-related during the first trimester. (Miscarriage during the first trimester is common for all women.) But as the pregnancy progresses, antiphospholipid antibody syndrome is usually to blame for miscarriage, which is common in women with lupus. Women should be screened before getting pregnant so they can be treated with aspirin and heparin to lower the risk.
Pre-eclampsia is also a major risk factor and is responsible for the high percentage of preterm births to women with lupus. The risks for this include active lupus, renal disease, and high-dose prednisone. High blood pressure in the second trimester is usually a warning that pre-eclampsia may occur.
Studies have found that pregnant women are more at risk of a lupus flare than their non-pregnant counterparts. This poses a big risk to the health of the woman and her unborn child, and can lead to complications such as diabetes, pre-eclampsia, and urinary tract infections.
Women with lupus are considered high-risk pregnancies and need to be monitored more closely by a specialist obstetrician. Unplanned pregnancies can be very high-risk for women with lupus. Taking certain medications in the early stages of pregnancy and lupus flares can be harmful to both mother and baby. Women are advised to try and plan their pregnancies carefully so they coincide with lupus remission.
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