Information provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases
Although pregnancy in women with lupus is considered high risk, most
women with lupus carry their babies safely to the end of their
pregnancy. Overall, women with lupus have a higher rate of miscarriage
and premature births compared with the general population. In addition,
women who have antiphospholipid antibodies are at a greater risk of
miscarriage in the second trimester because of their increased risk of
blood clotting in the placenta. Lupus patients with a history of kidney
disease have a higher risk of preeclampsia (hypertension with a buildup
of excess watery fluid in cells or tissues of the body). Pregnancy
counseling and planning before pregnancy are important. Ideally, a woman
should have no signs or symptoms of lupus and be taking no medications
for several months before she becomes pregnant.
Some women may experience a mild to moderate flare during or after their
pregnancy; others do not. Pregnant women with lupus, especially those
taking corticosteroids, also are more likely to develop high blood
pressure, diabetes, hyperglycemia (high blood sugar), and kidney
complications, so regular care and good nutrition during pregnancy are
essential. It is also advisable to have access to a neonatal (newborn)
intensive care unit at the time of delivery in case the baby requires
special medical attention.
For women with lupus who do not wish to become pregnant or who are
taking drugs that could be harmful to an unborn baby, reliable birth
control is important. Oral contraceptives (birth control pills) were
once not an option for women with lupus because doctors feared the
hormones in the pill would cause a flare of the disease. However, a
large NIH-supported study called Safety of Estrogens in Lupus
Erythematosus National Assessment (SELENA) found that severe flares were
no more common among women with lupus taking oral contraceptives than
those taking a placebo (inactive pill). As a result of this study,
doctors are increasingly prescribing oral contraceptives to women with
inactive or stable disease.
For more information on lupus and other musculoskeletal health issues, visit www.niams.nih.gov.
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