Preparing for Pregnancy with Autoimmune Diseases
If you have an autoimmune disease and want to get pregnant, it’s important to review your health status and medications with your NYU Langone rheumatologist, who specializes in treating pregnant women with these conditions. Women with lupus, antiphospholipid syndrome, rheumatoid arthritis, scleroderma, or Sjogren’s syndrome have what are considered high-risk pregnancies, meaning complications may be more likely than in other women.
If your doctor determines you are healthy enough for pregnancy, he or she can help you prepare.
At NYU Langone, our rheumatologists recommend that women with autoimmune diseases achieve remission, meaning their symptoms disappear or substantially improve, for at least six months before pregnancy. Women whose conditions are in remission typically have a reduced risk of pregnancy complications and symptom flare-ups.
Your doctor can adjust your medications and monitor your symptoms to help you achieve this goal.
Reviewing Your Medications
During pregnancy, certain medications prescribed for autoimmune conditions may be given in lower doses or replaced with safer ones. For instance, corticosteroids—potent anti-inflammatory medications—are prescribed at the lowest possible dose during pregnancy to decrease a woman’s risk of developing hypertension (high blood pressure), gestational diabetes, osteoporosis, premature rupture of the membranes, or preterm labor, as well as to reduce the baby’s risk of developing growth problems in the womb.
Your NYU Langone rheumatologist may prescribe anticoagulants, such as aspirin or low molecular weight heparin, to prevent blood clots from forming during pregnancy. These medications are typically prescribed for women with autoimmune conditions who test positive for antiphospholipid syndrome, an autoimmune disorder that causes abnormal blood clots.
Some pregnancy-related complications of antiphospholipid syndrome include recurrent miscarriages, stillbirth, and preeclampsia, or pregnancy-induced high blood pressure.
Exercise can help lessen fatigue and prevent joint stiffness in women with autoimmune diseases. Your doctor determines if exercise is safe for you during pregnancy and talks with you about the most appropriate light exercises for your condition.
Taking Dietary Supplements
Folic acid has been shown to reduce birth defects, so NYU Langone obstetricians recommend that women take at least 400 mcg of folic acid daily for three months before conception and throughout pregnancy.
Caffeine can decrease blood flow to the placenta, the temporary organ that nourishes the baby in the uterus, which may lead to fetal distress, usually indicated by the baby’s abnormal heart rate. Your doctor may recommend limiting the amount of caffeine you consume to less than 200 mg per day, the amount in one large cup of coffee, about 12 ounces.
Smoking can cause birth defects and lead to preeclampsia, miscarriage, and preterm labor, so it’s important that all women quit smoking before trying to conceive. Our doctors and therapists offer ways to help you quit for good through NYU Langone’s Tobacco Cessation Programs.