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Lupus and Lupus Kidney Disease - Lupus & Pregnancy

 

Any woman with lupus and kidney disease who wants to get pregnant should discuss her case in detail with her specialist first. The idea that doctors will ‘forbid‘ a woman from getting pregnant is not the case in the 21st century, but a number of risks should be discussed first. The main risks are:-

  • Problems caused by particular types of antibody in the blood. If someone has anti-cardiolipin antibodies or Ro antibodies (click here for details of what these antibodies are), there can be either miscarriage or problems with the baby's heart before birth. Women with anti-cardiolipin antibodies may need to have injections of a drug called heparin to anticoagulate the blood during pregnancy.
  • Lupus disease activity is generally reduced during pregnancy, but can increase after the baby is born.
  • Infections, particularly in the urine, can be more of a problem during pregnancy.
  • Drugs used for immunosuppression or treatment of other problems such as high blood pressure can cause problems to the baby. One of the important reasons for discussing pregnancy with a kidney specialist is to optimise drug treatments before getting pregnant. One drug often used to treat lupus, called mycophenolate, can cause developmental problems with a bab. It is very important that anyone taking mycophenolate who wants to become pregnant talks to their medical specialist before conception.
  • A baby can have a lupus syndrome for a short while after birth because of lupus antibodies in the mother’s blood, but this is normally a mild problem and gets better quickly.

Although this all sounds very negative, the author has seen many beautiful babies born to women with lupus, so do not despair, discuss the details of your individual case with your specialist! Some larger hospitals have clinics run by a kidney specialist and an obstetrician working together, to provide extra care for pregnant women with kidney diseases. Ask your GP or obstetrician about any such service in your area. It may be helpful to attend the clinic before planning pregnancy, to get advice about any changes in medication that might be made before becoming pregnant.

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The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

NKF Controlled Document No. 33: Lupus & Pregnancy written: 20/11/2000 last reviewed: 16/03/2015