Prognosis and Hope: Advancing technology and better understanding of the disease have improved pregnancy outcomes. Today, 80 percent of women with inactive lupus can have successful pregnancies. First, it is a great idea to learn about the issues and risks of pregnancy in lupus. Here are a few sources with reliable medical information:
First, here is a brief excerpt from the John Hopkin’s Arthritis Center article, Lupus and Pregnancy by Michelle Petri, M.D., M.P.H. This is a good place to start:
“Because lupus is a disease that strikes predominantly young women in the reproductive years, pregnancy is both a practical and a research issue. For most women with lupus, a successful pregnancy is possible. This is an immense change from the 1970’s, when most women with lupus were counseled not to become pregnant. Studies of the immune system in pregnancy are of interest for what they have taught us about the effect of hormones on lupus flares.”
The Johns Hopkins article continues with an excellent overview of lupus and pregnancy concerns and risks of miscarriage, preterm birth and intrauterine growth retardation, as well lupus risks mother and baby during pregnancy.
Next, the Lupus Foundation of America (LFA) answers an important question on the minds of young women with lupus, in their article, Pregnancy and Lupus:
“When Is The Best Time To Get Pregnant?”
“The answer is simple: when you are at your healthiest. Women in SLE remission have much less trouble than do women with active disease. Their babies do much better, and everyone worries less. Good health rules are essential: eat well, take medications as prescribed, visit your doctor(s) regularly, don’t smoke, don’t drink, and certainly don’t use “recreational” drugs.”
Finally, I recommend reading the National Institutes of Health (NIH) in their publication, Lupus: A Patient Care Guide for Nurses and Other Health Professionals, 3rd Edition, 2006. The Patient Information Sheet #11, Pregnancy and Lupus, offers eight excellent care guidelines for a woman with lupus to follow during her pregnancy at their interactive educational site.
“Caring for Yourself
- Keep all of your appointments with your primary doctor and your obstetrician.
- Get enough rest. Plan for a good night’s sleep and rest periods throughout the day.
- Eat a sensible, well-balanced diet. Avoid excessive weight gain. Have your obstetrician refer you to a registered dietitian if necessary.
- Take your medications as prescribed. Your doctor may have you stop some medications and start or continue others.
- Don’t smoke, and don’t drink alcoholic beverages.
- Be sure your doctor or nurse reviews with you the normal body changes that occur during pregnancy. Some of these changes may be similar to those that occur with a lupus flare. Although it is up to the doctor to determine whether the changes are normal or represent the development of a flare, you must be familiar with them so that you can report them as soon as they occur.
- If you are not sure about a problem or begin to notice a change in the way you feel, talk to your doctor right away.
- Ask your doctor or nurse about participating in childbirth preparation and parenting classes. Although you have lupus, you have the same needs as any other new mother-to-be.”
While I have had the blessings of 2 successful pregnancies in the years before I was diagnosed with lupus, I also had one unsuccessful pregnancy in between the birth of my daughter and my son. After a long day of yard work and excessive sun exposure in the 12th week of my second pregnancy, the next day I became very sick and miscarried my baby. I will always wonder whether knowing then that I had lupus might have helped me know better how to change my behavior to lower risks to me and the baby, and if perhaps knowing how to better care for me and my unborn baby, the outcome might have been very different. Only God truly knows!