Precautions for marriage and pregnancy in patients with lupus erythematosus

  SLE patients are mostly young women in the age of love, marriage and childbirth. Whether they can get married and have children is a concern for many patients, and we should know that the psychological, physical and sexual functions of SLE patients are no different from those of normal people. Therefore, when the disease activity is controlled and the condition is in remission, marriage can be considered under the guidance of the doctor’s factory. Until the disease fails to allow pregnancy, contraceptive pills should be avoided and estrogen-free contraceptive methods are generally recommended.  When the disease is in remission. It is generally advocated that pregnancy can be considered under the guidance of a physician when the disease has been in remission for more than one year on prednisone ≤1O mg/day. Our experience with 80 SLE pregnancies and deliveries shows that the risk of pregnancy can be minimized with the cooperation of rheumatologists and obstetricians and gynecologists when the above conditions are met.  Patients without severe damage to the central nervous system, kidneys, or other organs and who are in remission for more than six months are generally able to safely conceive and deliver normal babies. Patients with SLE who are not in remission are prone to miscarriage, preterm birth and stillbirth, with an incidence of about 30%, so contraception should be used. The use of cyclophosphamide, methotrexate and azathioprine during the first 3 months of pregnancy may affect the growth and development of the fetus, so these drugs must be stopped for at least 3 months before pregnancy.  Pregnancy can trigger SLE activity, especially in early pregnancy and 6 weeks after delivery. Those with a history of habitual abortion or positive antiphospholipid antibodies should take low-dose aspirin (50 mg/d) during pregnancy. Hormones are inactivated during placental passage (with the exception of dexamethasone and betamethasone) and are not harmful to the fetus, and hormone therapy may be given during pregnancy and for one month after delivery as needed. Avoid breastfeeding after delivery.