Lupus: Support and Survival
Pregnancy, Babies, and Neonatal LupusWomen with lupus have a very hard time holding a pregnancy till full term. In the last 15 years, a greater number of women with Lupus are having children with very little problems due to increased knowledge of Lupus.
- Currently, more than 50% of all lupus pregnancies are completely normal.
- 25% of women with lupus deliver normal babies prematurely.
- Fetal loss, due to spontaneous abortion (miscarriage) or death of the baby, accounts for less than 20 percent.
- Not all of the problems of pregnancy with lupus have been solved, but pregnancies are possible, and normal children are the rule.
Premature birth is the greatest danger to the baby. Births before 36 weeks are considered premature.
About 50% of lupus pregnancies end before 40 weeks (9 months), usually because of complications with blood clots and high blood pressure. Babies born after 30 weeks, or weighing more than 3 pounds, usually do well and grow normally.
Premature babies may have these problems, but in modern neonatal units they can be easily treated:
There is no unusual frequency of mental retardation in babies of lupus mothers.
- difficulty breathing
- developing jaundice
- becoming anemic.
- Even babies as small as 1 pound, 4 ounces have survived and have been healthy in every way; but the outcome is uncertain for babies of this size.
Will My Baby Have Lupus?
About 33% of people with lupus have an antibody known as the anti-Ro, or anti-SSA, antibody. About 10% of women with anti-Ro antibodies (about 3% of all women with lupus) will have a baby with a syndrome known as "neonatal lupus."
Neonatal lupus is not SLE. Neonatal lupus consists of:
- a transient rash
- transient blood count abnormalities
- sometimes a special type of heart beat abnormality. If the heart beat abnormality occurs, which is very rare, it is treatable but it is permanent.
Neonatal lupus is the only type of congenital abnormality found in children of mothers with lupus. For babies with neonatal lupus who do not have the heart problem, there is no trace of the disease by 3-6 months of age, and it does not recur.
Even babies with the heart beat abnormality problem grow normally.
If a mother has had one child with neonatal lupus, there is about a 25% chance of having another child with the same problem. There is only a small chance that the child will develop systemic lupus erythematosus later in life.
Will I Have To Have A Caesarian Section?
Birth by Caesarian section is both the safest and fastest method of delivery in the following cases:
- very premature babies
- babies showing signs of stress
- babies of mothers with low platelets
- babies of mothers who are very ill.
Usually the decision about type of delivery is not made in advance because the specific circumstances at the time of delivery are the determining factors.
Can I Breast Feed?
Breast-feeding is certainly possible for women with lupus. However, breast milk may not come if the baby is born very prematurely. Very premature babies are not strong enough to suckle, and thus cannot draw the milk.
Milk can be pumped from the breast to feed a premature baby if the mother wishes to do this. Also, some medications, such as prednisone, may prevent milk from being produced.
If you are taking any medication it is best not to breast-feed, unless your doctor approves. For example, Plaquenil and the cytotoxic drugs (Cytoxan, Imuran) are passed through the milk to the baby.
Who Will Care For The Baby In The Case Of Active Lupus?
Prospective parents often do not ask what will happen after the baby is born if the mother is ill and unable to care for the child. Since it is likely that a woman with lupus will have future periods of illness, it is wise to think of this possibility in advance and to have plans for alternate child care (spouse, grandparent, etc.) if needed.
Pregnancy and having children is possible for patients with Lupus. As long as the mother is monitored closely for any blood abnormalities during the pregnancy. This will allow the doctor to stem any problems that would cause a demise of the baby.
A healthy baby is possible.
Contact the Lupus Foundation of America or the local Chapter that serves your area for more information about lupus, or the programs and services the LFA offers including support group information and physician referral.
Lupus Foundation of America., Inc.
1300 Piccard Drive, Suite 200
Rockville, MD 20850-4303
Searching for ways to deal with the depression, the frustrations, the questions about lupus, I joined a support group online. LUPIES has been a wonderful gift. I have learned more from the information I found on the support web site from other sufferers of Lupus than I did from my doctor. Thank you fellow Lupies! May your days be pain free!
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