Post Date December, 03 2023
Patients with lupus nephritis can have normal fertility under certain conditions, but many patients with lupus nephritis are prone to develop or worsen their condition during pregnancy. Therefore, patients with lupus nephritis need to choose the best timing for pregnancy.
Pregnancy is not allowed until 6 months after remission of lupus nephritis
Due to the fact that systemic lupus erythematosus can affect many important organs throughout the body, it can lead to systemic lupus nephritis. The activity of systemic lupus erythematosus nephritis has adverse effects on both mother and baby, and is a contraindication of pregnancy. Therefore, it is usually recommended to start pregnancy after the remission of systemic lupus erythematosus nephritis exceeds 6 months. During pregnancy, close monitoring of the activity of systemic lupus erythematosus nephritis should be carried out.
Anti Ro and La antibodies can cause neonatal lupus syndrome
Secondly, anti Ro and La antibodies can cause neonatal lupus syndrome: lupus patients often have positive anti Ro and/or anti La antibodies, which can be transmitted to the fetus through the placenta after 16 weeks of pregnancy, resulting in mother to child transmission. Fetuses can develop neonatal lupus syndrome after birth, with a mortality rate of up to 20%. Survivors often require the insertion of permanent pacemakers.
High incidence of obstetric complications in patients with lupus nephritis
In addition, the incidence of obstetric complications in patients with systemic lupus erythematosus nephropathy is high: the incidence of hypertension during pregnancy in lupus patients is as high as 25%, often leading to an increased incidence of obstetric complications such as preeclampsia and intrauterine growth retardation (IUGR). Some lupus patients with antiphospholipid antibody syndrome (APS) are characterized by thrombosis, habitual miscarriage, intrauterine growth retardation, and premature birth.
Therefore, patients with systemic lupus erythematosus nephritis must carefully consider before planning their pregnancy. The optimal timing for pregnancy is: no important organs are involved, the condition is stable for at least six months, the dosage of prednisone is less than 10 mg/d, the use of various immunosuppressants prohibited during pregnancy is stopped for more than six months, renal function is normal, urine protein is negative (less than 0.5 g of urine protein within 24 hours), and antiphospholipid antibodies turn negative for more than three months.
