Living with Lupus

Pregnancy & Lupus: What to Know

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#LupusWarriors that are pregnant have a great chance of having healthy, happy, and normal experiences. Understand more about certain risks and advocate for you and your baby’s health.

A pregnancy alongside lupus presents additional challenges and risks that should be managed. All lupus pregnancies are considered high-risk—however, less than 50% of lupus pregnancies have complications.

Every woman has a different journey during pregnancy. Kind of like a science experiment, each woman has different indicators and reactions causing slight or significant departures from normal functions. When dealing with lupus, these manifestations from pregnancy might seem like lupus flares—it’s important to be able to distinguish between the two.

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Before a Pregnancy

Planning is key to having a healthy pregnancy for #LupusWarriors. Before conception, talk to your lupus treatment team about concerns and their recommendations. Rheumatologists might suggest adding a perinatologist or high-risk obstetrician and a pediatric cardiologist.

Risks for the Baby

Again, there are great chances for #LupusWarriors to have healthy pregnancies. Some women even state their lupus symptoms decreased during their pregnancies. But, if flare ups occur during pregnancies, there are concerns and measures must be taken.

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Risk of miscarriage

Before—(if it’s possible to notice one is coming)—during, and/or after a flare up, immediately make an appointment with the medical provider to ensure the baby’s health. SLE can increase the rate of the two types of miscarriage. A fetal death in utero—a missed abortion—is when the products of conception need to be evacuated. A spontaneous abortion is when there is the passing of some or all of the tissue.

Any miscarriage is traumatizing. #LupusWarriors who have active disease states are most likely to experience miscarriages in the second or third trimester. In addition to physical health, it is important to value the importance of mental health during a pregnancy as well. Family and friends can be great resources as can mental health professionals.

Miscarriages in the first trimester have no profound effect on the mother’s body and usually are unnoticed until a doctor determines the unfortunate event. If a #LupusWarrior experiences a miscarriage in the first trimester, it is most likely independent of lupus.

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Neonatal Lupus

Neonatal lupus is pretty rare—but it does happen. This congenital condition is when the autoantibodies of the mother travel to the baby. Individuals with neonatal lupus more often than not only have one affected organ.

The most common complication of neonatal lupus is a prominent skin rash. Just like a rash during a lupus flare, the baby will have red, scaly lesions on the body. Neonatal lupus that only expresses skin rash, is most of the time transient—it disappears shortly after birth.

Neonatal lupus that exhibits heart block as the congenital defect, is more complicated and severe. If neonatal lupus’ main manifestation is the heart, this could develop in the second or third trimester. A heart block is when there are abnormal beats.

This is why it’s extremely important for #LupusWarriors to gather a medical team consisting of a pediatric cardiologist and a high-risk obstetrician as well as to be aware of a potential premature delivery.

Other symptoms of neonatal lupus that are less common are an enlarged liver and spleen and macrocephaly.

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Risks for the Mom

The mother has a high risk of developing preeclampsia. Preeclampsia is when a woman experiences high-blood pressure and an increased amount of protein in the urine. Protein in the urine is a definite sign of unhealthy kidneys. Kidneys that are damaged by disease allow protein to leak from the blood to urine.

Preeclampsia can develop slowly starting from the second or first trimester or acutely such as the onset of labor. If a pregnant woman has a flare during pregnancy, renal disease (kidney dysfunction) is a strong possibility. For #LupusWarriors, if the body attacks the kidneys during a flare, it could strongly lead to preeclamptic symptoms.

Symptoms of preeclampsia are swollen feet, legs, and hands. Feet and legs swell with normal pregnancies. So, it’s important for #LupusWarriors to really monitor their swelling in the body.

Lupus Pregnancies and Treatment

Providers might prescribe medication during lupus pregnancies. Common drug treatments consist of steroid in low doses and the cautious use of immunosuppressive drugs.

lupus-pregnancies

What to Take Away

#LupusWarriors that are pregnant are considered high-risk pregnancies. But many times there are no severe complications. Armed with the right information, be an advocate for you and your baby’s health. Drink plenty of water, eat a healthy diet, and avoid gaining too much weight.

The birth of a child is a beautiful thing. Be informed, observant, and enjoy every second of the journey. Congratulations to all future moms!

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