It used to be that doctors told women with lupus that it was best for them not to get pregnant because of the high risk of potential complications.
However, it is entirely possible for women with lupus to have healthy babies. Lupus pregnancies are considered high risk, though, and moms-to-be will be very closely monitored.
The Risks of a Lupus Pregnancy
It is estimated that approximately 10 percent of lupus pregnancies end in miscarriage and there is often no obvious lupus-related cause particularly for losses within the first trimester. (1)
Preeclampsia (toxemia or high blood pressure) occurs in about 20 percent of lupus pregnancies. (2)
The next highest risk is an increase in antiphospholipid antibodies (approximately 33 percent). (2) These can cause blood clots in the placenta, even with the mother taking blood thinners.
The highest risk comes with pre-term births born before 37 weeks, and occurs in 50 percent of lupus pregnancies. (2, 3)
Baby Concerns with a Lupus Pregnancy
Many lupus mothers worry that their baby will be born with lupus, or other medical or cognitive conditions as a result of the mother’s disease.
The answers to some of the most frequent questions and concerns are below:
• There is no unusual occurrence of mental development issues in babies born to Lupus mothers.
• Premature babies may experience breathing difficulties, anemia or jaundice, but these conditions are easily treatable with today’s neonatal technology. Even very premature babies (25 weeks or 1 pound) survive and grow into healthy children. (2)
• The only congenital abnormality in babies born to lupus mothers is “neonatal” lupus (about 3 percent). The baby will have a rash, blood count abnormalities and, sometimes, arrhythmia (abnormal heart beat). The rash and blood count disappear during the neonatal period.
By 3 to 6 months of age there are no more symptoms. A baby who exhibits the heart abnormality will grow normally, but may require placement of a pacemaker in the future. (2)
Steroids Affect Breast Milk Production
• Steroids used to treat lupus symptoms or flare ups can interfere with breast milk production. This produces an extra challenge in that very premature babies are unable to suckle which is integral to the supply/demand relationship that stimulates milk production.
Because certain medications can also pass through the breast milk, they may need to be changed, or the decision made to use formula. (2)
• Many lupus mothers experience flare ups of their symptoms after the baby is born, and it may mean that a mother may not be able to care for the newborn. It is important to have a plan in place to help you manage the care of your newborn. (2)
Sources:
1. Lupus and Pregnancy. Petri, Michelle. The Johns Hopkins Arthritis Center. Web. July 22, 2012.
http://www.hopkinslupus.org/lupus-info/lifestyle-additional-information/lupus-pregnancy
2. Pregnancy and Lupus. Lupus Foundation of America, Inc. Web. July 22, 2012.
http://www.lupus.org/webmodules/webarticlesnet/templates/new_donate.aspx?a=314&z=6&page=1
3. Pregnancy and Lupus. WebMD. Web. July 22, 2012.
http://lupus.webmd.com/guide/pregnancy-lupus
Reviewed August 27, 2012
by Michele Blacksberg RN
Edited by Jody Smith