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Preg­nancy

Preg­nancy with lupus is possible.

In the past, doc­tors advised against preg­nancy in indi­vidu­als with lupus. Today, lupus is no longer a bar­ri­er. You should def­in­itely dis­cuss a planned preg­nancy with your treat­ing doc­tor. Ther­apies must be adjusted. 

From a med­ic­al per­spect­ive, there is no obstacle to preg­nancy if low dis­ease activ­ity has been present for at least 4–6 months before planned con­cep­tion and no severe organ dam­age exists. If lupus is stable and quiet at the time of con­cep­tion, the risks of dis­ease flares and preg­nancy com­plic­a­tions are sig­ni­fic­antly lower than with high dis­ease activity. 

Pos­sible Risks

Preg­nancy in indi­vidu­als with lupus is a high-risk pregnancy. 

Cer­tain risks exist for both the moth­er and the child. Preg­nant indi­vidu­als exper­i­ence an above-aver­age num­ber of flares and lupus activ­ity. Addi­tion­ally, com­plic­a­tions occur more fre­quently, such as car­di­ovas­cu­lar prob­lems like pree­clamp­sia, high blood pres­sure, throm­bos­is, inflam­ma­tion of the heart muscle or peri­car­di­um. For the fetus and embryo, there are high­er prob­ab­il­it­ies of mis­car­riage, growth delays, and pre­ma­ture birth. 

To reduce the risks, it is import­ant to plan a preg­nancy early and care­fully. A con­sulta­tion at a spe­cial­ized clin­ic is recom­men­ded as soon as there is a desire to have children.

Dur­ing Pregnancy

Fun­da­ment­ally, dis­ease and preg­nancy mon­it­or­ing must be adap­ted to the indi­vidu­al risk of the per­son with lupus.

Since this is a high-risk preg­nancy, preg­nancy mon­it­or­ing occurs more fre­quently in indi­vidu­als with lupus than in healthy indi­vidu­als. Lupus activ­ity should be mon­itored every 4–6 weeks, espe­cially in the second half of pregnancy. 

It is often neces­sary to switch ther­apy to preg­nancy-com­pat­ible med­ic­a­tions before con­cep­tion. How­ever, all med­ic­a­tions should by no means be dis­con­tin­ued before a planned pregnancy. 

After Preg­nancy

It is import­ant for indi­vidu­als with lupus to be well informed and cared for by an inter­dis­cip­lin­ary team of specialists.

Increased lupus activ­ity often occurs after preg­nancy. There­fore, doc­tors usu­ally mon­it­or lupus patients some­what more closely after birth. 

Fur­ther Information

Addi­tion­al inform­a­tion can be found via the links Inselspit­al Bern and Rheum­at­o­logy & Immunology.

The lupus suisse magazine on the top­ic “Desire for Chil­dren in Women with Lupus!” is worth reading.

Inselspit­al: Preg­nancy with Rheum­at­ic Disease