For a young woman, receiving a diagnosis of systemic lupus erythematosus means questioning the possibility of having children. In fact, some women believe that this autoimmune disease can cause infertility. True or false? Professor Carlo Selmi, Head of Clinical Rheumatology and Immunology at Humanitas and Professor at the University of Milan, answers.
“False. Systemic lupus erythematosus (SLE) affects women of childbearing age and in some cases, especially if antiphospholipid antibodies are present, it can cause repeated abortions and thus reduce fertility, i.e. the ability to have a child,” the expert explains. It is also true that pregnancy can exacerbate the disease by increasing the risk of complications for the mother and fetus. For this reason, until a few years ago, women were strongly advised against pregnancy, especially in the presence of risk factors such as nephritis, or during therapy with immunosuppressive drugs or specific antibodies. Along with worsening kidney function and arterial hypertension, and an increased thromboembolic risk to the mother, a woman with SLE has a higher risk than healthy women of miscarriage and preeclampsia, also known as pregnancy that puts a woman’s life at risk, while the fetus increases the risk of preterm birth, neonatal or skin lupus syndrome, and severe congenital heart disease. Today, however, a greater knowledge of the disease has allowed women with systemic lupus erythematosus to become mothers and breastfeed their baby, thanks to the introduction of latest generation drugs, a greater understanding of the disease and, above all, the planning of pregnancy with their rheumatologist. In fact, as shown by a study conducted by the Department of Rheumatology and Clinical Immunology of Humanitas Research in collaboration with the University of California, planning pregnancy during the period of inactivity or remission of the disease, increases the chances of completing a successful pregnancy, reducing or avoiding the complications known to mother and child.