Lupus during pregnancy: Everything you need to know

Lupus is a long-term condition that can lead to a number of different symptoms.

Having lupus doesn’t mean that you can’t get pregnant, but it does mean that your pregnancy journey will be different and that there are certain things you must be aware of and plan for.

To help you, we’ve put together a guide that covers many of the key points about being pregnant with lupus...

What is lupus?

Lupus is an auto-immune disease, which means that it causes your immune system to attack healthy parts of your body. Anyone can get it, but women are more prone to lupus than men and it is more prevalent in Asian and black people. Symptoms differ between patients, but include extreme tiredness, pain and swelling in the joints, and rashes. If you have lupus you may experience periodic flare-ups followed by periods of remission that can last weeks or longer, while others endure persistent lupus symptoms that never go away.

What are the causes of lupus?

Doctors don’t know exactly what causes lupus, but research suggests it may be related to puberty, menopause, childbirth and certain medicines.

Are there any pregnancy complications associated with lupus?

Lupus can also lead to high blood pressure in pregnancy, which in turn makes you more prone to pre-eclampsia -  a condition that can cause headaches, vision problems and swelling. Although it’s normally nothing to worry about, if pre-eclampsia is not treated it can develop into something more serious. Lupus in pregnancy also increases the likelihood of miscarriage, which affects about 1 in 5 pregnancies of mothers with lupus.

Are there any risks to my baby from lupus?

Having lupus in pregnancy does mean more risks for your baby, as it increases the likelihood of premature delivery and poor growth. But you should remember that most babies born to mothers with lupus are perfectly healthy.

Do I need to tell my doctor if I’m planning to get pregnant?

Yes, you should speak to your doctor as soon as you think about trying for a baby. They will advise that your lupus should be under control (in remission) for at least six months before you get pregnant, as it can be dangerous for your baby if you become pregnant while you have active lupus. Your doctor may also recommend different drugs and treatments that are better for pregnancy and you may need to make some of these changes before you get pregnant.

Will I get different care during pregnancy if I have lupus?

Yes, as you and your baby will be more closely monitored during your pregnancy, due to the higher risk of complications. The more active your lupus is, the more care and monitoring you will receive. 

Will lupus in pregnancy have an effect on my labour and delivery?

Maybe. Although many women with lupus in pregnancy can have a vaginal delivery, you may be recommended for a caesarean section, or induced early, as the medical team see it as the safer option for you and your baby.

Will my baby be born with lupus?

Most baby’s born to mothers with lupus are entirely healthy. But there is a small risk that your baby could be born with a condition called neonatal lupus. This is different from adult lupus but can cause rashes, liver problems, and low blood cell levels, and – in severe cases – a slow heart rate, which will eventually need to be treated with a pacemaker. About 3% of babies born to mums with lupus are affected by the condition, but in most cases it disappears around the age of 6 to 8 months and doesn’t come back.  

Can pregnancy trigger lupus flares?

Yes, you may find that your lupus flares up during your pregnancy, although some symptoms - such as swollen joints and tiredness – are also common in pregnancy, which can make it difficult to know what’s causing the problem. If you think you are experiencing a flare up, then you must speak to your doctor immediately. You may not be certain if the symptoms are related to lupus or pregnancy, but it’s always best to be safe and get help if you’re at all worried.