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Lupus and Pregnancy

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What is lupus?

Lupus is a disease that can affect different parts of the body, such as the skin, joints, blood, and kidneys. Lupus is an auto-immune disease. It is caused by a problem with the body’s immune system. The immune system normally makes “antibodies” that protect the body against viruses, bacteria, and other invaders (antigens). In an auto-immune disorder, the immune system attacks the body’s own cells as if they were invaders. This can cause inflammation, injury to tissue, and pain. 

People with lupus often have “flares,” when the symptoms are bad. In between the flares, the symptoms are not so bad. This is called “remission” (ree-MISS-shun).

When should I get pregnant?

If you have lupus and are thinking about having a baby, you should talk with your doctors. Your rheumatologist and obstetrician will need to work together as a team during your pregnancy.

Before becoming pregnant

  • You should wait 5 to 6 months after the last flare of lupus. It is better to be in remission for a healthier pregnancy.
  • Check with your doctors about any medicine you are taking to make sure that you can take it during pregnancy.
  • You may need to be tested for the presence of the anti-phospholipid (anti-FOSS-foh-LIP-id) antibody, the lupus anti-coagulant (anti-co-AGyou-lent), and the anti-cardiolipin
    (anti-CAR-dee-o-LIP-in) antibody. About 33 percent of women with lupus have these antibodies.
  • Many patients with lupus take the medicine hydroxycholoquine (brand name Plaquenil®). This medicine can be taken during pregnancy.

Is my pregnancy high-risk?

All lupus pregnancies are high-risk. It is very important for you to see your doctors often to help keep you and your baby healthy. Many problems can be prevented. Any problems that are found can be more easily treated if they are found early.

With lupus, you may be at risk for some of the following problems:

  • Women who have the anti-phospholipid or the anti-cardiolipin antibodies may be more at risk for blood clots. This includes blood clots in the placenta. The placenta delivers food and oxygen from the mother to the baby. Blood clots can block this delivery. This would slow the baby’s growth and put the baby in danger.
  • Women with lupus are at risk for early delivery and need to keep all doctor appointments.
  • About 20 percent of women with lupus may develop pre-eclampsia (also known as toxemia of pregnancy or pregnancy induced hypertension). Pre-eclampsia involves sudden increase in blood pressure and/or protein in the urine, swelling, headaches, and in some cases, seizures. This is serious and needs immediate medical treatment. Sometimes the doctor needs to deliver the baby early.
  • Cesarean birth may be necessary if the mother becomes very ill or the baby is in distress.

It is very important to keep scheduled appointments with your obstetrician and rheumatologist.

Will my baby have lupus?

Lupus rarely occurs in children whose mother had lupus. About 60 to 70 percent of people with lupus have an antibody known as Anti-Ro or anti-SSA antibody. Of these women, about 90 percent will have a normal baby. About 5 percent will have a baby with neonatal lupus. This may cause:

  • A rash of the face, scalp, or chest
  • Blood count problems
  • A possible heartbeat problem

For babies with neonatal lupus and no heart problem, there is no trace of the disease by 3 to 6 months of age. The heartbeat problem is rare and can be treated. Even though it is permanent, babies with the heartbeat abnormality grow normally.

Can I breastfeed my baby?

You can breastfeed your baby if you have lupus. Be sure to check with your doctors about any medicine you may be taking, because some medicines are passed through the breast milk.

Some premature babies are not strong enough to suckle. If you wish, you can express your milk to feed your baby until your baby is strong enough to nurse.

Will I need help with my baby?

All new mothers can sometimes use some help. It is a good idea to make plans so that you will have help with the baby when you need it.

For more information

You can contact the Lupus Foundation of America Inc. at 1-800-558-0121 .
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