How autoimmune disorders affect your pregnancy

Pregnant and have an autoimmune condition? Make sure to get good medical support for the sake of your baby’s health….

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When a person’s own immune system attacks her body thinking that healthy cells are a threat, an autoimmune disease occurs. Such disorders are more common amongst women, especially those of reproductive age, say studies.

In the past, women who had autoimmune disorders were discouraged from having children as this put both the baby’s and mum-to-be’s lives at risk. Luckily, medicine has evolved to such an extent that women dealing with such disorders have great medical support and can still enjoy healthy pregnancies. The most common autoimmune disorders affecting women of childbearing age are:

  • Antiphospholipid syndrome (or APS) Blood clots form too easily or excessively.
  • Systemic lupus erythematosus (SLE) Affects the skin, joints, kidneys, brain, and other organs.
  • Rheumatoid arthritis Causes damage to the hip joints or lower (lumbar) spine.
  • Grave’s disease An overactive thyroid gland makes too much thyroid hormone, producing symptoms like rapid weight loss, anxiety, tremors, insomnia, irregular menses, chest pains and heat intolerance.
  • Hashimoto’s disease Causes an underproduction of thyroid hormones. Symptoms include, depression, fatigue, muscle aches, unexplained weight gain and prolonged menses.
  • Type 1 diabetes mellitus The body is unable to produce insulin as the beta cells in the pancreas are destroyed by the autoimmune disorder. Symptoms include, nausea, blurred vision and unexplained weight loss.

While it’s advisable to get the condition under control (ideally, you should be in remission before trying for a child), none of these conditions should pose a problem to your fertility or pregnancy if the condition is well managed well, assured doctors SmartParents spoke to.

Obstetrician-gynaecologist experts, Dr Chris Chong of Gleneagles Medical Centre and Dr Tony Tan of Raffles Hospital, answer your pressing questions if you have an autoimuune condition and are trying to get pregnant or already pregnant…

In the past, women who had autoimmune disorders were discouraged from having children as this put both the baby’s and mum-to-be’s lives at risk.

What maternal health complications commonly occur with an auto-immune disease?
Complications depend on which area of the woman’s health that is being compromised by the disorder ― while thyroid conditions are generally manageable, joint problems may worsen and hurt more as the pregnancy progresses. Kidney and heart diseases can pose problems throughout the gestational period. Most medications are also relatively safe to take despite limited data for its use in pregnancy. In fact, not taking the medications when the disease flares up could be a much worse scenario.

Dr Chong In the first trimester there’s a risk of miscarriage, vomiting and bleeding. With all the other trimesters, issues can arise with blood pressure, renal damage or failure and the placenta separating from the baby. The medications she takes can also cause side effects like anaemia, water retention and muscles wasting away from steroids.
Dr Tan In the first trimester, look out for miscarriages and the role of the medication in causing teratogenic effects [birth defects] on the baby. The risk of miscarriages may be increased if there is antiphospholipid syndrome [elevated levels of antibodies causing recurrent foetal loss]. Medication should be reviewed to ensure that those with better data in pregnancy are used.  She will also have to get regular checks for blood pressure and a urine dipstick test to check for proteinuria [excess protein in the urine] to detect pre-eclampsia. These are common complications of autoimmune disorders. 

Can autoimmune disorders pose a health threat to the baby…? Read on!