Lupus and Pregnancy - What You Should Know

12 June, 2020
Women with lupus who are going through pregnancy or who want to become pregnant should consider a few things. It's definitely possible to carry a pregnancy to term while having this disease, but you must be in control.

What should we do about the link between lupus and pregnancy? Especially in this era in which the therapeutic management of the disease has significantly improved. In fact, the adverse effects can be removed with drug treatment.

Keep in mind that a large part of the complications from having lupus and being pregnant has to do with pharmacology. This is because the medications prescribed to contain lupus attacks often cause infertility or fetus malformations.

It’s for this reason that women with lupus are always instructed to plan their pregnancy well in advance. This is so that doctors have time to adapt the treatment to it. This is currently possible, thanks to the development of active principles that pretty much make the previous ones obsolete.

In this article, you’ll see how women suffering from lupus disease can have a safe pregnancy if they plan it properly. They’ll have to undergo more controls and tests than other pregnant women without this condition. However, it’s definitely viable.

What’s lupus?

Lupus is an autoimmune disease. This means that the immune system attacks its own cells as it doesn’t recognize them. For instance, it identifies some tissues as external or threatening and inflames them with a reaction similar to that which occurs when fighting viral or bacterial diseases.

The pathology is chronic and evolves in the form of exacerbated negative reactions. Periods of inactivity may occur where there are no symptoms, but then the acute episodes that occur are severe and disabling.

The tissues that are most affected by lupus are the articular, dermal, and renal. There’s also the involvement of the lungs and brain, although its characteristic symptoms stem from the joints and skin.

When we talk about lupus and pregnancy we’re referring to a woman with a previous diagnosis of lupus who becomes pregnant at some point afterward. This can be problematic, because some records reveal an increase in the incidence of pregnancy problems in women with this condition.

In addition, there’s a possibility, which doesn’t always happen, that scientists refer to as neonatal lupus. This happens when the baby receives the antibodies that cause lupus in their mother. This child will, most likely, have skin and blood problems, and, in severe cases, may also end up with heart problems.

A woman with a rash on her cheeks.
Lupus has a characteristic symptom on the skin of the face, shaped like butterfly wings.

Keep reading: What You Should Know About Lupus

Medication for lupus and infertility

When we talk about lupus and pregnancy we must first talk about lupus and fertility. The truth is that women with the disease shouldn’t have more difficulty than others in getting pregnant, although medication plays a key role here.

People with lupus use medication that can alter their ability to gestate. For example, cyclophosphamide is a frequent drug used for lupus but it alters the viability of the ovaries in the long term.

Therefore, it’s important that women who want to become pregnant and have a diagnosis of lupus, consult their doctor well in advance. Therapeutic plans can be modified to promote fertility. What some doctors do is add leuprolide, another drug, to cyclophosphamide, which reduces infertility.

Similarly, several lupus drugs are teratogenic. What this means is they can cause birth defects in the fetus, especially during the first trimester. It’s another matter to plan in advance with the doctor who’s treating them.

Medication for Lupus.
Lupus medication is one of the big problems when a woman gets pregnant.

Find out more: Seven Remedies for Controlling Lupus

Complications of lupus during pregnancy

Lupus can complicate pregnancy in comparison to a woman without that problem. Among the most frequent problems:

  • Hypercoagulation. A pregnant woman with lupus may be prone to clots, which interrupt the blood flow to the placenta.
  • Miscarriage. Women with lupus are 10% more likely to have a miscarriage than other pregnant women.
  • Preeclampsia. This syndrome consists of an increase in the blood pressure of a woman with lupus, with edema in the lower limbs, and protein losses in the urine. It’s a type of high blood pressure that, although it’s usually induced by pregnancy, is attributed to lupus in these cases.
  • Preterm labor. The above conditions can speed up labor and bring birth forward — each on its own.

Lupus and pregnancy are compatible

Despite the complications, lupus and pregnancy are definitely compatible. Women diagnosed with the disease who plan on getting pregnant should consult their doctor to plan it as much as they can and well in advance. The proper development of their baby will depend on this planning.

Thanks for reading, we hope you’ve enjoyed this article.

  • Rivera Chavez, Lizet Lorena, et al. “Brote severo de lupus de difícil control.” Nefrología 39.3 (2019): 321.
  • Ucar, E., et al. “Manejo del lupus eritematoso sistémico durante el embarazo.” Revista Española de Reumatología 32.3 (2005): 91-98.
  • Martínez, Alonzo, et al. “Detección y manejo del brote lúpico en el embarazo.” Progresos de Obstetricia y Ginecología 61.4 (2018): 365-369.