Does Lupus Cause Miscarriages?

Women With Lupus Can Have Healthy Pregnancies

A pregnant woman experiencing pain.
A pregnant woman experiencing pain. IAN HOOTON/SPL/Getty Images

Though it is sobering news, it's important for women with lupus to know that about 10 to 20 percent of lupus pregnancies end in unexpected miscarriages or stillbirths. This rate is higher than average.

That said, women with lupus who wish to get pregnant certainly can – and can experience a normal pregnancy and delivery as well. But it is important that a lupus pregnancy be monitored by an obstetrician experienced in managing high-risk pregnancies and who can work closely with your primary doctor.

How Miscarriages Occur In Women With Lupus

Generally speaking, first-trimester miscarriages in women with lupus either have no known cause or are considered the possible result of active lupus.

When lupus patients lose a pregnancy in later trimesters, it can often be attributed to antiphospholipid antibody syndrome. This condition is also known as antiphospholipid syndrome or APS.

People with APS make abnormal proteins called antiphospholipid autoantibodies. These antibodies interfere with the normal function of blood vessels and can lead to narrowing of the blood vessels or blood clots. This can lead to miscarriage. (Beyond miscarriage, these complications also can lead to stroke and heart attack.)

Although these antibodies were first discovered in lupus patients, you don’t have to have the disease to carry the antibodies. Typically, 50 percent of people who carry the antibodies don't have lupus.

Planning for a Healthy Pregnancy

It's best to become pregnant when your lupus is in remission. Women who have active lupus are more likely to experience pregnancy complications such as miscarriage.

The Lupus Foundation of America recommends that women with lupus meet with their doctor three to six months before trying to become pregnant.

Your doctor may recommend that you stop taking some - but not all - of your medications.

Other Miscarriage Causes

Even if you have lupus, a miscarriage may not be the result of your condition. Other factors beyond lupus can contribute to miscarriage.

The most common is a chromosomal abnormality in the fetus, usually resulting from a problem with the sperm or egg that prevents proper fetus development.

Second-trimester complications with the uterus or cervix can also cause a miscarriage. Other disorders, such as polycystic ovarian syndrome, increase the risk for miscarriage as well.

Remember, though, that women who miscarry can and often carry a pregnancy to full-term.

How to Know If You Had a Miscarriage

Signs and symptoms of a miscarriage can include:

  • Vaginal spotting or bleeding
  • Cramping or abdominal pain
  • Fluid or tissue passing from the vagina

Some vaginal bleeding - specifically spotting early in pregnancy - may not indicate a potential miscarriage. Regardless, contact your health care provider immediately if you experience these symptoms.

Sources:

Antiphospholipid Syndrome. American College of Rheumatology. May 2015.

Can I still plan a pregnancy? Lupus Foundation of America. July 11, 2013.

Antiphospholipid Antibodies. Lupus Foundation of America. August 2008.

Lupus Anticoagulant. William Matsui, MD, Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network. February 2007. Miscarriage.

Eunice Kennedy Shriver National Institute of Child Health and Human Development. May 2007.

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