Pregnancy and lupus

Women with lupus can safely get pregnant and most will have normal pregnancies and healthy babies. However, all women with lupus who get pregnant are considered to have a “high risk pregnancy.” This means that problems during pregnancy may be more likely for women with lupus. It doesn’t mean there will definitely be problems.

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I have lupus and want to have a baby. Is it safe for me to get pregnant?

Yes. Women with lupus can safely become pregnant. If your disease is under control, pregnancy is unlikely to cause flares. However, you will need to start planning for pregnancy well before you get pregnant. 

  • Your disease should be under control or in remission for six months before you get pregnant. Getting pregnant when your lupus is active could result in miscarriage, stillbirth, or other serious health problems for you or your baby.
  • Pregnancy is very risky for certain groups of women with lupus. These include women with high blood pressure, lung disease, heart failure, chronic kidney failure, kidney disease, or a history of preeclampsia. It also may include women who have had a stroke or a lupus flare within the past six months.

You will need to find an obstetrician (a doctor who is specially trained to care for women during pregnancy) who manages high-risk pregnancies and who can work closely with your regular doctor.

How does pregnancy affect lupus?

Pregnant women with lupus have a higher risk for certain pregnancy complications than women who do not have lupus. You may also have other problems that happen during pregnancy.

  • You may get flares during pregnancy. The flares happen most often in the first or second trimester. Most flares are mild. But some flares require medicine right away or may cause you to deliver early.1 Always call your doctor right away if you get the warning signs of a lupus flare.
  • About 2 in 10 pregnant women with lupus get preeclampsia,2 a serious condition that must be treated right away. The risk of preeclampsia is higher in women with lupus who have a history of kidney disease. If you get preeclampsia, you might notice sudden weight gain, swelling of the hands and face, blurred vision, dizziness, or stomach pain. You might have to deliver your baby early.
  • Pregnancy can raise your risk for other problems, especially if you take corticosteroids. These problems include high blood pressure, diabetes, and kidney problems. Good nutrition during pregnancy can help prevent these problems during pregnancy. Regular doctor visits can help find problems like these early so they can be treated to keep you and your baby as healthy as possible.

How can I tell if the changes in my body are normal during pregnancy or a sign of a flare?

You may not be able to tell the difference between changes in your body due to pregnancy and warning signs of a lupus flare. Tell your doctor about any new symptoms. You and your doctor can figure out whether your symptoms are because of your pregnancy or your lupus. This way, you can help prevent or control any flares that do happen.

I have lupus and am pregnant. Will my baby be healthy?

Most likely, yes. Most babies born to mothers with lupus are healthy.

Rarely, infants are born with a condition called neonatal lupus. Certain antibodies found in the mother can cause neonatal lupus. At birth, an infant with neonatal lupus may have a skin rash, liver problems, or low blood cell levels.

Infants with neonatal lupus can develop a serious heart defect called congenital heart block. But, in most babies, neonatal lupus goes away after three to six months and does not come back.

Your doctor will test for neonatal lupus during your pregnancy. Treatment can also begin at or before birth.

Can I breastfeed if I have lupus?

Yes. Breastfeeding is possible for mothers with lupus. However, some medicines can pass through your breastmilk to your infant. Talk to your doctor or nurse about whether breastfeeding is safe with the medicines you use to control your lupus.

Visit our Breastfeeding section to learn more. You can also enter your medicine into the LactMed® database to find out if your medicine passes through your breastmilk and any possible side effects for your nursing baby.

Did we answer your question about pregnancy and lupus?

For more information about pregnancy and lupus, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

Sources

  1. Longo, D.L., et al. (2012). Harrison’s Principles of Internal Medicine, 18th edition.
  2. Clowse, M. (2007). Lupus Activity in Pregnancy. Rheum Dis Clin North Am; 33(237).