Antibodies to Ro/SSA
Neonatal lupus (NL) occurs in a baby when autoantibodies are passively transferred from mother to fetus during pregnancy. NL is associated with the presence of Ro or SSA antibodies in the mother, and can cause transient rashes, low blood counts, elevated liver tests, or permanent Congenital Heart Block (CHB). A baby with neonatal lupus does NOT have systemic lupus and is not at an elevated risk for developing lupus or other rheumatic disease.
Antiphospholipid Syndrome (APS) is a rare condition in which antiphospholipid autoantibodies cause blood clots and/or pregnancy complications. A patient may have antiphospholipid antibodies (aPL) and not have any clinical criteria for APS. A patient with elevated aPL but NO clinical features of APS, should NOT be considered to have APS.
A patient should be assessed for aPL when considering an estrogen-containing contraceptive and/or prior to or early in pregnancy.
Inflammatory arthritis (IA), which includes rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS) and other spondyloarthropathies, and juvenile inflammatory arthritis (JIA), typically does not interfere with pregnancy success. Most women deliver a healthy full-term baby. However, active arthritis does increase the risk for preterm birth and can cause the mother pain and disability.
Pregnancy can be a risky time for all people, and these risks are higher for patients with Lupus Systemic Lupus Erythematosus (SLE, lupus). Fortunately, many of these risks can be decreased with careful planning and management. However, some of these risks persist even with our best treatments. This is a key reason that patients with lupus should be evaluated by a maternal-fetal medicine (MFM, perinatalogist) obstetrician.
While there is very limited data about pregnancy in women living with vasculitis, we can take lessons from other rheumatic diseases to guide birth control and pregnancy management. Pregnancy is safest when vasculitis is well-controlled with pregnancy-compatible medications. Most women with vasculitis can use any birth control they prefer, though some caution is advised for women at high risk for blood clots.