Pregnancy and Lupus

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 and 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 three-six months of age, and it does not recur. Most babies with the heart beat abnormality problem grow normally, but some need pacemakers. If a mother has had one child with neonatal lupus, there is about a 25 percent chance of having another child with the same problem. The chance that the child will develop systemic lupus erythematosus later in life is very, very low.

Will I Have To Have A Caesarian Section?

Very premature babies, babies showing signs of stress, babies of mothers with low platelets, and babies of mothers who are very ill are almost always delivered by Caesarian section. This is both the safest and fastest method of delivery in these cases. 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?

Although breast feeding is possible for women with lupus, 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. However, milk can be pumped from the breast to feed a premature baby if the mother wishes to do this. Plaquenil and the cytotoxic drugs (Cytoxan, Imuran) are passed through the milk to the baby. Some medications, such as prednisone, may prevent milk from being produced. Many drugs, including warfarin (Coumadin), heparin, and low doses of prednisone, are safe. If you are taking any medication it is best not to breast feed; but if your doctor approves, you may.

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.

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