If you or someone you love has lupus, the idea of pregnancy may feel overwhelming.

During pregnancy, the body goes through significant changes. For people with lupus, those changes can affect disease activity and may increase the risk of flares or pregnancy complications.

People with lupus can become pregnant and deliver healthy babies, but there are additional considerations. Careful planning and regular monitoring are a key part of the journey.

In this article, we explore everything you need to know about lupus and pregnancy, including what to consider before, during, and after a pregnancy and birth.

Understanding lupus

Lupus, or systemic lupus erythematosus (SLE), is an autoimmune condition characterized by immune system overactivity. 

In people with lupus, the immune system mistakenly targets healthy cells in the body’s organs and tissues, causing inflammation.

This inflammation can affect many different parts of the body, including the skin, blood vessels, joints, kidneys, brain, heart, and lungs. Depending on which areas are affected, lupus can cause a wide range of symptoms and complications.

This immune system overactivity can also affect the reproductive organs, which can impact fertility and the ability to conceive.

Preparing for pregnancy with lupus

If you are living with lupus and planning a pregnancy, it’s best to speak to your doctor 3–6 months before trying to conceive.

As part of planning a healthy pregnancy, your doctor may ask you questions about:

• Your current lupus medications
• Your blood pressure
• History of kidney problems
• History of blood clots or antiphospholipid antibody testing

Ideally, the best time to become pregnant is when your lupus is stable and has been in remission for a prolonged period. 

It’s important to bear in mind that not all lupus medications are safe during pregnancy. Working with your doctor, you can create a discontinuation plan to ensure that you are no longer taking harmful medications when trying to conceive. 

Important note: Even if your lupus is well-controlled, pregnancy still involves risks. Speaking to your doctor before trying to conceive can help you better understand potential complications and plan for a safer pregnancy.

During pregnancy

Close monitoring during pregnancy is very important.

Working with your primary care doctor, rheumatologists, and obstetric team, you will have additional appointments to track your progress and assess for potential complications.

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Lupus pregnancy complications

Many people with lupus have healthy, uncomplicated pregnancies. But there are still risks, and being aware of them is key to catching potentially life-threatening complications early.

Premature birth

Preterm, or premature, birth occurs when a baby is born before 37 weeks of gestation. While approximately 10% of all births are preterm, the risk rises to around 30% for people with lupus.

Premature birth carries risks for the baby, including respiratory distress syndrome (RDS), sepsis, and hemorrhage. Depending on how premature the baby is, they will likely need medical care in a neonatal intensive care unit (NICU).

Growth problems

Babies born to people with lupus have a higher risk of below-average birth weight or size. Your medical team will monitor the baby’s development closely throughout your pregnancy.

Miscarriage or stillbirth

There is an increased risk of spontaneous miscarriage or stillbirth in lupus pregnancies.

Miscarriage, the unexpected loss of a pregnancy before 20 weeks of gestation, can occur in 20–25% of lupus pregnancies.

The risk of stillbirth, which is defined as fetal loss between 20 and 28 weeks of gestation, is also elevated in lupus pregnancies.

Your medical team will recommend additional appointments to monitor the fetus throughout your pregnancy due to these elevated risk factors.

Preeclampsia

Having lupus and becoming pregnant raises the risk of preeclampsia.

Preeclampsia is a serious and potentially life-threatening condition that can arise after 20 weeks of gestation. It involves high blood pressure and signs of organ stress or damage.

Preeclampsia can lead to serious complications if not carefully monitored and treated, including seizures, stroke, and issues with the placenta

Reducing the risk of preeclampsia often involves careful monitoring throughout pregnancy. Depending on your individual risk factors and medical history, your doctor may also recommend medications to help lower the risk of complications.

Postpartum lupus considerations

After you give birth, continued monitoring can help ensure the best outcome for you and your baby.

Neonatal lupus

Many parents are concerned that lupus will pass to their infant, but systemic lupus is not passed from parent to child in this way.

That being said, some babies born to parents with lupus develop neonatal lupus, which is a specific form of the condition.

Neonatal lupus is rare, affecting about 2% of lupus pregnancies. It often causes temporary symptoms in the body after birth, including skin rashes that typically disappear within a year.

In rare cases, neonatal lupus can impact the baby’s heart, causing an autoimmune congenital heart block. This condition is often treatable, but it can be life-threatening in its most severe form.

Track your pregnancy and lupus together

Pregnancy is an exciting and life-changing time, but it can be especially overwhelming if you have an autoimmune condition like lupus.

Having lupus does not mean you cannot become a parent. Many people with lupus become pregnant and have healthy babies. Your condition just means that a safe pregnancy involves additional planning and monitoring.

Health tracking tools like the Human Health app can help you stay on top of your health before, during, and after pregnancy. With the app, you can log symptoms, flare days, and medication changes in one place, so nothing gets missed between appointments.

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Frequently asked questions

Can I have a baby if I have lupus?

Yes. Most people with lupus can become pregnant and deliver safely with the condition. However, the pregnancy will be considered high-risk.

Additional planning, monitoring, and support from specialists like rheumatologists and obstetricians may be required to help keep the parent and baby safe.

Does lupus affect fertility?

Yes, lupus can impact fertility, but it rarely causes complete infertility.

Research in this area is still evolving, but factors such as active disease, certain medications, and changes in ovarian reserve may make conception more difficult for some people.

How does being pregnant affect lupus symptoms?

Becoming pregnant can increase your risk of experiencing lupus flares.

Pregnancy causes significant hormonal and immune system changes, which may affect lupus disease activity in some people. This can cause common lupus symptoms, including skin rashes, joint pain, and fatigue, to increase.

Disclaimer: Human Health is a health tracking platform and does not provide medical advice, diagnosis, or treatment. The information in this guide is for educational purposes only and is not a substitute for professional medical care. Always consult your doctor or healthcare provider with questions about your health.

Sources:

1. Systemic Lupus Erythematosus Management in Pregnancy (2022)
2. Lupus and pregnancy, The Lupus Foundation of America
3. Systemic lupus erythematosus is associated with an increased frequency of spontaneous preterm births: systematic review and meta-analysis (2024)
4. Complications of Preterm Birth—The Importance of Care for the Outcome: A Narrative Review (2024)
5. Pregnancy characteristics of patients with systemic lupus erythematosus with different onset times and their risk of adverse pregnancy outcomes: a retrospective cohort study (2025)
6. Pregnancy and lupus, Lupus Canada
7. Early-onset preeclampsia in lupus pregnancy (2018)
8. Neonatal Lupus Erythematosus (2026)‍
9. Infertility in systemic lupus erythematosus: what rheumatologists need to know in a new age of assisted reproductive technology (2022)