
Lupus is an autoimmune disease, which leads to chronic inflammation that can damage any part of the body. The onset can occur at any age, but it's most common in people between the ages of 20 and 50, and is significantly more prevalent in women than men.
Therefore, many women with lupus find themselves wondering how it will impact childbearing. Greg DeLorenzo MD, a rheumatologist at Group Health, answers common questions you may have and shares tips for having a safe, healthy pregnancy.
Pregnancy with lupus does carry a set of risks, but “for the most part, if someone has treated and controlled lupus, there’s no reason why they couldn’t get pregnant or shouldn’t get pregnant,” Dr. DeLorenzo explains.
There are no definitive guidelines; however, Dr. DeLorenzo recommends making sure your last lupus outbreak has been under control for at least three months.
Many women believe pregnancy can cause a lupus flare-up, but studies show that’s not the case. However, he reminds women that a flare-up during pregnancy can be very detrimental – even fatal – to the fetus, and therefore, your pregnancy will need to be monitored closely. “Patients can flare with lupus, but the pregnancy itself doesn’t necessarily cause a flare,” he explains.
If you have lupus and are pregnant, you will need more frequent doctor visits. Also, depending on the comfort level and experience of your obstetrician, he or she may refer you to a high-risk obstetrician. You will also need to keep your rheumatologist informed, so they can monitor you throughout your pregnancy to make sure a lupus flare-up isn’t starting.
Women with lupus tend to be more prone to clot miscarriages, Dr. DeLorenzo says. “There’s an associated condition, called antiphospholipid syndrome, which some lupus patients can have, and that’s what actually makes them very prone to recurrent miscarriages. There’s medication they can use to treat that, to get them through the pregnancy.”
If there are no complications, Dr. DeLorenzo says you should be able to have a standard, vaginal delivery.
Dr. DeLorenzo stresses the importance of being proactive. “Before you’re trying to conceive, let your ob-gyn and rheumatologist know – to be evaluated … Some tests could be done that might predict whether they may have some complications during pregnancy.”