Lupus And Pregnancy

Contents:

• Symptoms of Lupus in Pregnancy
• Lupus Complications in Pregnancy
• Is Lupus Transmitted From Mother to Baby
• Lupus Prevention in Pregnancy

Lupus During Pregnancy

Lupus in pregnancy is a chronic inflammatory autoimmune disease that in 90 % of cases affects women. Immune system protects the body against viruses, germs, bacteria, and other harmful microorganisms, but in case of autoimmune diseases, your own cells may be recognized as foreign. This can cause inflammation affecting many organs, including kidneys, skin, joints, heart, lungs and blood cells. Severe inflammation may cause chronic pain, tissue damage and internal organs destruction.

Unfortunately, there is no drug against lupus, but medications and lifestyle changes can ease the symptoms and prevent the organs’ destruction.

Lupus is a chronic disease that can disappear for a while, but not forever. Most people suffer from mild symptoms, which alternate with flares of the disease, then the disease retreats again. During a flare, the symptoms include fatigue, fever, rash, joint pain, swelling, hair loss, increased sensitivity to light and drastic weight loss. Then the flare subsides, the disease goes into remission. People with lupus can also suffer from chest pain, shortness of breath and renal problems.

Symptoms of Lupus in Pregnancy

Flares of lupus can occur in any trimester of pregnancy. They can be both mild and severe, and the most common symptoms of such flares are arthritis, rash and fatigue.

It is very important to distinguish the symptoms of lupus from normal changes that occur in the body during pregnancy. For example, joint pain can be caused not by lupus, but by the weight gain and shifting of the center of gravity.

Many women notice enhanced hair growth during pregnancy and then dramatic hair loss after the birth. Although hair loss and is a symptom of lupus, in this case it is more likely caused by the postpartum hormonal changes.

Lupus Complications in Pregnancy

Pregnant women with lupus are risking developing certain complications. If you become pregnant when lupus was in the active stage, or if you have experienced severe flares of disease during pregnancy, you are likely to have the following complications:

• Pre-eclampsia – about 13 % of women with lupus suffer from hypertension, and have protein in the urine. These are the symptoms of a serious condition known as preeclampsia, which requires immediate treatment, and even preterm birth in some cases. Pre-eclampsia affects 3-8 % of pregnant women, the women with renal disease associated with lupus (lupus nephritis), have high risks of pre-eclampsia.
• Miscarriages – about 25 % of pregnancies in lupus end in miscarriage or stillbirth. It is to be noticed that 10-20 % of all pregnancies end in miscarriage.
• Preterm birth – about 25 % of children born to mothers with lupus are preterm. The preterm birth is caused not only by the disease itself, but also by the medications administrated to treat it.
• Obstruction of the fetal growth -children of mothers with lupus are at a higher risk of intrauterine growth retardation (IUGR), which means that the baby may be much smaller than expected. The doctor may diagnose the fetal growth retardation using ultrasound. The intrauterine growth retardation occurs in approximately 15 % of pregnancies with lupus. This risk can be increased, if the pregnant woman suffers from pre-eclampsia, or if she receives steroid and immunosuppressive treatment during pregnancy.
• Placental thrombosis – some pregnant women with lupus have antibodies, which contribute to the formation of blood clots (thrombosis) in the placenta. These clots obstruct normal placental growth and functioning. As the baby receives vital nutrients via placenta, the presence of blood clots can slow the baby's growth.

Is Lupus Transmitted From Mother to Baby

• About 5 % of children born to a mother with lupus also suffer from this illness.
• About 2 % of women who have anti-Ro and anti-La antibodies, are likely to have a baby with neonatal lupus which is characterized by the rash and a small amount of platelets in the blood. This condition usually subsists when the baby is 3-6 months. It is very unlikely that the baby with neonatal lupus will develop systemic lupus in the future.

In some cases, a child born to a woman with lupus may develop heart problems. This condition is chronic, but treatable, usually a pacemaker, which regulates the heartbeat of the baby, is used. If a woman had given birth to a child with neonatal lupus, the chance that her next child will also have this disease is about 25 %.

Lupus Prevention in Pregnancy

Good care of yourself during pregnancy can prevent flare-ups of lupus and increase your chances to give birth to a healthy baby.

That is the list of things to do:

• Get plenty of rest. All pregnant women need long sleep, but pregnant women with lupus need to sleep even more.
• Protect yourself from the sun. Ultraviolet radiation can cause the outbreak of the disease. You can reduce the risk by using protective clothing and sunscreen when you are outdoors.
• Don't neglect your doctor’s recommendations. A woman with lupus should be examined more carefully than a typical pregnant woman. It is very important to follow all the doctor’s advice to make it easier to your obstetrician-gynecologist to monitor the emergence of the symptoms of lupus.
• Keep to a well-balanced diet. A healthy diet must include fruit, vegetables and grains. If you have high blood pressure, your doctor may advise you to cut salt consumption. If you need help in making a diet, your doctor may refer you to a dietitian.
• Do not smoke. Smoking increases the risk of cardiovascular disease and may exacerbate the effects of lupus on the heart and blood vessels. Moreover, it's bad for your growing baby, regardless the presence of lupus.