Lupus & Pregnancy

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Lupus in pregnancy is a great question. Women with lupus thinking about having a baby will have additional concerns. The Lupus Community Navigator received a question about lupus and pregnancy and we reached out to Dr. Rosalind Ramsey-Goldman, MD, DrPH, Solovy/Arthritis Research Society Research Professor at Northwestern Medicine to answer the questions.

Questions:
What research, medication, medical conversations have been had about pregnancy and lupus patients (women in general and black women specifically)

I’m interested in knowing if there is medication I can take to prevent miscarriage due to lupus? Is pregnancy safe at all for women with lupus ? Are there changes in flares while pregnant ? Chance of flares after pregnancy?

Response:
Pregnancy is a complicated issue and should be discussed in detail with the doctor who is treating you for lupus. We (Northwestern Medicine) also specialize in that type of counseling if second opinions are requested.

Research has shown that preconception counseling (preparing in advance) with a team of doctors shows best results for pregnancy.

Get the potential mother’s lupus disease under control and if needed switch to medications that can be used during pregnancy

Work with a high risk obstetrics group (doctor that delivers babies) as they are more comfortable caring for mothers with chronic illnesses. Other specialists may need to be involved if lupus has affected many areas of the body.

During pregnancy flares can still occur but they happen less often if mother was doing ok before pregnancy. It may mean taking medication (see comment above about medication). A mother with disease controlled is the best situation for a good baby outcome.

Flares can also occur after pregnancy. The strategy to minimize this risk is to carefully check on the mother after delivery with the same careful oversight as during pregnancy to see if there are any hints that the disease will flare so we can treat quickly if needed.

For the average lupus pregnancy there is no specific medication to prevent a miscarriage. As noted before the mother should have her disease controlled prior to getting pregnant. There is one specific circumstance where treatment might cause a miscarriage and this is if the mother has certain antibodies in her blood which should be known if the mother went through the counseling prior to getting pregnant. The doctor will determine based on her lupus history, prior pregnancy history if she has been pregnant before, if the presence of these antibodies is clinically important to recommend treatment.

Contact the Lupus Community Navigator (info@lupusil.org or 312-542-0002) with lupus related questions and concern.

This information is for educational and informational purposes only and serve to benefit our mission. The Lupus Society of Illinois (LSI) does not provide medical advice or recommendations. This information should not substitute or replace expert medical care. Before making changes to your medical care, consult your qualified healthcare professionals familiar with your medical condition and health status.

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