Pregnancy and Lupus
Doctors once advised women with lupus not to get pregnant due to the potential risks to mother and baby. But while pregnancy with lupus still carries its own set of risks, most women with lupus can safely become pregnant and have healthy babies.
If you have lupus and are thinking about getting pregnant, here's what you need to know about the possible risks and complications. Here's also what you and your doctor can do to help ensure the best outcome for you and your baby.
Preparing for Pregnancy
The first steps toward a healthy pregnancy and baby begin before you become pregnant. If you are considering pregnancy, it's important that you:
Ensure your lupus is under control. The healthier you are when you conceive, the greater your chances of having a healthy pregnancy and baby. Pregnancy places additional stress on kidneys. Having active kidney disease can cause problems in pregnancy and may even lead to pregnancy loss. So if possible, avoid getting pregnant until your lupus has been under control for at least six months. That's especially true for lupus-related kidney disease.
Review medications with your doctor. Some medications are safe to take during pregnancy. Others, though, can harm your baby. Your doctor may need to stop or switch some medications before you become pregnant. Drugs that should not be taken during pregnancy include methotrexate, cyclophosphamide, mycophenolate mofetil, leflunomide, and warfarin. Some drugs need to be stopped months before you try to become pregnant.
Select an obstetrician for high-risk pregnancies. Because lupus may present certain risks -- including pregnancy-induced hypertension and preterm birth -- you will need an obstetrician who has experience with high-risk pregnancies and is at a hospital that specializes in high-risk deliveries. If possible, you should meet with the obstetrician before getting pregnant.
Check your health insurance plan. Inadequate insurance should not keep you from getting the treatment that you and your baby need. Make sure your insurance plan covers your health care needs and those of your baby, as well as any problems that may arise.
Managing Problems of Pregnancy
Regular prenatal exams are important for all women. But they are especially important for women with lupus. That's because many potential problems can be prevented or better treated if addressed early. Here are some problems that can occur during pregnancy that you should be aware of:
Flares. Some women report improvement of lupus symptoms during pregnancy. But flares during pregnancy occur in up to 30% of women. Periods of increased disease activity occur more often during the first few months after delivery. Research suggests that waiting to get pregnant until your disease has been controlled for at least six months reduces your risk of a flare during pregnancy. Most flares, when they do occur, are mild. Your doctor can often treat them with low doses of corticosteroids.