Lupus (a variety of which is called systemic lupus erythematosus or SLE) is common in women, especially during child-bearing years, and can affect pregnancy. As many as one in 750 women has SLE, and it may explain why you've been having miscarriages. Although half the pregnancies in women who have lupus are completely fine, a quarter result in premature birth and, in the remaining quarter, the baby is lost through miscarriage or stillbirth.
You'll need specialist care (which may involve drug treatment), ideally from a rheumatologist or other consultant with experience of SLE in pregnancy, to make the risk to you and your baby as low as possible.
You may have to travel some distance to see a specialist, as pregnancy clinics that treat women with lupus are few and far between - St Thomas' Hospital in London runs one, for example. Talk to your GP and explain you're pregnant again so need to see a specialist as early as possible.
What is lupus?
Lupus is an autoimmune disease that causes chronic inflammation in the skin, joints, blood and kidneys, as well as other parts of the body. It tends to fluctuate in severity, flaring up when the body is challenged by certain triggers. It's up to 15 times more common in women than men.
The cause isn't known, but has been linked to environmental factors such as infection, drug treatments (including some antibiotics), ultraviolet light and stress. There may also be a genetic predisposition to the disease.
Lupus can affect the unborn baby
If you have lupus it may affect the unborn baby in a variety of ways. For example, if it affects your kidneys there's an increased risk the baby will be stillborn. You may develop symptoms similar to pre-eclampsia (protein in the urine, swelling or oedema, raised blood pressure, and so on) and the baby's growth may be slow.
Other problems include premature birth, a transient rash on the baby's head and, in rare cases, damage to the baby's electrical conduction system in the heart, causing abnormal heart rhythms.
There is also a link with a condition called antiphospholipid syndrome or Hughes syndrome. A significant number of women with SLE have this blood-clotting disorder, too, which is an important cause of miscarriage in SLE.
Among women under 40, Hughes syndrome may cause a quarter of all miscarriages, but can, in many cases, be simply treated with just a small daily dose of aspirin.
Pregnancy can make lupus worse
Not only does lupus affect pregnancy, but pregnancy can aggravate lupus. It often gets worse during pregnancy or the early weeks afterwards, although rarely severely. In up to 15 per cent of cases, lupus actually improves in pregnancy.
St Thomas' Lupus Trust and Lupus UKhave more detailed information.
This article was last medically reviewed by Dr Trisha Macnair in April 2008
