El Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease, which is characterized by the presence of a multitude of antibodies. Although it appears at any age, it mainly manifests itself in women of childbearing age. Nine out of ten people with lupus are women. If you are thinking of getting pregnant and are diagnosed with this disease, you will have to consult with your doctor about the risks that you, or the baby, run.
Generally lupus does not affect fertility, but it can lead to certain complications During pregnancy. It will be your clinical status prior to pregnancy that determines the entire process. Most women with lupus have a safe, yet controlled pregnancy by delivering healthy babies, who can be breastfed by their mothers.
How does lupus affect future pregnancy?
The origin of lupus is still unknown, they have been linked genetic, hormonal, environmental factors, cellular alterations and alteration in the balance of cytokines. Its clinical picture is very heterogeneous, it already affects almost any organ. Its main manifestations are: joint and skin alterations, with characteristic erythema in butterfly wings in the malar area, photosensitivity, pleurisy and pericarditis, kidney involvement, osteoporosis and blood and immunological alterations.
As you probably already know, lupus cannot be cured but you can control it with various treatments. It is recommended that women with lupus who want to become pregnant plan pregnancy. The disease must be controlled or in remission for about six months before becoming pregnant and the kidney involvement, if any, has disappeared.
Since lupus does not affect the fertility of women with lupus, except for those who are treated with cyclophosphamide, it is important to use effective contraception when the disease is in an active phase. When lupus is active, it increases the risk of miscarriage, stillbirth, or other serious conditions. Those women who undergo in vitro fertilization may also have a reactivation during ovulation induction.
Possible complications during pregnancy
Lupus can get worse during pregnancy. The flare-ups almost always occur in the first or second trimester, and they are usually mild. Inform your doctor about any new symptoms, because you may require medication immediately or, if it is the case, decide to induce and advance labor. Some medicines taken as a treatment can seriously harm the baby.
Pregnant women with lupus have a increased risk of certain complications than those that don't. Preeclampsia occurs in 13% of women with lupus, and in two out of ten women diagnosed and also have already had a history of kidney diseases.
Pregnancy can also increase the risk of other problems, especially if you take corticosteroids, such as hypertension, diabetes and kidney problems. Women with lung diseases, heart failure, chronic kidney failure, kidney disease prior to lupus, but as a consequence of it, are considered high-risk pregnancies.
Can my baby be born with lupus?
La most babies born to mothers with this disease are healthy. There is a condition that is neonatal lupus, which, although it is rare for it to be transmitted, can occur that certain antibodies present in the mother cause it. Your gynecologist will give you a test before the baby is born to find out if you have it. Treatment can be started at birth or earlier.
A baby with neonatal lupus may have a skin rash, liver problems, or low levels of red blood cells. 90% of these children will not develop it later, and it is usually reversible between the first 6 and 8 months of life. It does not reappear. In very severe cases they develop a serious heart defect, congenital heart block.
Breastfeeding is the best feeding option for the newborn, and it is possible if you have lupus, but do not forget to follow the recommendations of your specialist. Some medications can pass to your baby through breast milk, such as cyclophosphamide and methotrexate.