Scleroderma and Pregnancy
Planning to have a baby can be an exciting time in a couple’s life. But if you have systemic sclerosis, or scleroderma, the excitement can be tempered by concerns related to your disease: Will scleroderma affect my baby’s development? Will being pregnant make my scleroderma worse? Will scleroderma complicate my delivery or affect my ability to breast feed or take care of my child?
Planning a pregnancy?
1.There is no evidence that having scleroderma will affect your ability to get pregnant, so it’s important to practice effective birth control until you decide the time is right for you to have a child.
2. If you think you’d like to start a family, it’s important to wait at least three years after your scleroderma diagnosis to become pregnant. During the first three years the course of the disease can be unpredictable, and flares are more likely.
3. Pre-planning will allow you and your rheumatologist to make sure disease activity is low while on pregnancy-compatible medications.
Disease activity during pregnancy:
If your disease is stable when you become pregnant, research suggests that it’s likely to stay that way throughout pregnancy. In one study of 133 pregnancies in women with scleroderma, 5 percent experienced improvement and 7 percent experienced symptom worsening, while symptoms remained stable in the remaining 88 percent.
Other research has shown that some symptoms, including Raynaud’s phenomenon and finger ulcers, are likely to improve during pregnancy while heartburn (a common complain among pregnant women with or without scleroderma) tends to worsen
Monitoring baby: Your doctors will monitor you for complications throughout pregnancy. If you test positive for anti-Ro (SSA) and anti-LA (SSB) antibodies this will include monitoring the baby’s heart until the 25th week of pregnancy.
How will I deliver?
While most women with scleroderma can deliver vaginally, any complications with your or the baby could necessitate an early delivery by C-section.
Will I be able to breast feed?
If you’d like to breastfeed, scleroderma won’t prevent you from doing so, if your disease is well-controlled. While you can’t pass scleroderma to your baby, you can pass along some medications, so it’s important to speak with your doctor about drugs that are safe.
What should I expect after delivery?
Disease activity: If you notice worsening of symptoms, contact your rheumatologist, because some women experience increased disease activity after delivery. And even if your disease is stable, childbirth and caring for a newborn is exhausting, so fatigue is common with new motherhood.
Medication and breast feeding: If controlling your disease after delivery requires a change in medication, be sure to let your doctor know if you are breastfeeding. Many medications, but not all, are safe for breastfeeding.
John Hopkins Scleroderma Center
American College of Rheumatology