Pregnancy and Neonatal Lupus

If you have lupus, you may be worried about how it will affect your baby and whether your baby will develop neonatal lupus erythematosus, commonly referred to as neonatal lupus. This rare condition affects about one to three percent of infants born to women who have systemic lupus erythematosus and other autoimmune conditions such as Sjögren's syndrome and Raynaud's phenomenon.

Neonatal lupus is caused by antibodies that travel across the placenta and into the fetus's bloodstream. It's also possible for mothers who don't have lupus or any other autoimmune condition to have babies with neonatal lupus, such as women who suffer from hyperthyroidism.

Research on pregnancy and neonatal lupus has come a long way. About two decades ago, it wasn't uncommon for doctors to advise women with lupus to have therapeutic abortions. Today, the majority of women with lupus can have safe pregnancies.

According to the Lupus Foundation of American (LFA), proper medical care can lower complications associated with pregnancy so you deliver a normal, health baby. It all begins with a carefully planned pregnancy.

  • Get your lupus under control. If you're concerned about pregnancy and neonatal lupus, strive to get your condition under control or in remission before becoming pregnant. According NIAMS, if you become pregnant when your disease is active, you could have a miscarriage, stillbirth, or other serious adverse effects.

  • Work with a specialist in high-risk pregnancies. Because all lupus pregnancies are considered "high risk," the LFA recommends that you get an obstetrician who specializes in high-risk pregnancies. You'll need to be closely monitored from conception until delivery, and you should give birth in a facility that supports high-risk births. Make sure you don't skip any appointments.

  • Be flexible about delivery. If you're like many moms, you probably want to experience a vaginal delivery. However, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) points out that this may not be possible. About 50 percent of lupus pregnancies end in premature delivery, according to the LFA. It's considered safer to deliver babies of high-risk pregnancies, or babies under stress by cesarean section.

  • Manage your disease closely. Neonatal lupus may be a major worry for you, but don't try to self-manage your disease. Make sure you follow your doctor's advice. Stick to your drug plan, which may be adjusted during your pregnancy. Don't stop taking a drug without the advice of your doctor. Other precautions that are good for controlling lupus are also good for your pregnancy and baby. Don't gain too much weight, get lots of rest, quit smoking or drinking, and eat healthy, nutritious meals.

  • Know what to expect. As mentioned, there's a 50 percent chance your baby may be premature. In addition, NIAMS reports that about 10 percent of lupus pregnancies end in miscarriage. If your baby has neonatal lupus she still may have a temporary rash, and liver and blood count abnormalities.

About 30 percent of babies born with neonatal lupus have a heart block, which affects the wiring of the heart. If your baby doesn't have a heart block, you may be reassured to know that the neonatal lupus will go away within three to six months and not return, according to the LFA. If your baby has a heart block, a pacemaker can help and your baby will likely grow up normally.

  • Prepare for postpartum. As there's a higher chance that your pregnancy may result in premature delivery, you should be aware that preemies--whether they have neonatal lupus or not--have more difficulty breastfeeding. Consider expressing your milk instead and feeding your baby through a bottle.

When breastfeeding, you may not able to take corticosteroid drugs because they affect your milk supply, and other drugs may be dangerous for your baby. Consult with your doctor about the best drugs to take during this period.

Also, a happy mom makes for a happy baby. Get plenty of support after delivery, take time for yourself, and find ways to reduce postpartum stress.

Did you know? Some scientists dispute the use of the term "neonatal lupus" because only 25 percent of mothers whose babies have neonatal lupus meet the criteria for systemic lupus erythematosus