Lupus May Increase Risk for Gestational Diabetes

Most people living with lupus have successful pregnancies and births. Modern medicine has made it safer than ever to be pregnant with lupus. But a pregnancy while living with lupus is still considered a "high-risk pregnancy." A 2021 study found that lupus doubles the risk for gestational diabetes.^1-3

Gestational diabetes

Gestational diabetes is a type of diabetes that only occurs in people who are pregnant. It happens when your blood sugar is higher than it should be.⁴

You are at more risk for developing gestational diabetes if you have a family history of gestational diabetes or are:⁴

• Age 35 or older
• Overweight
• Already living with diabetes

Gestational diabetes is common. In the United States, it occurs in about 2 to 10 percent of all pregnancies. It goes away after you give birth.⁴

Lupus and gestational diabetes

The study compared pregnancies in people with lupus to those without lupus. It found that pregnant people with lupus are twice as likely to develop gestational diabetes as people who do not have lupus.³

The study’s researchers collected data from 695 pregnant people with lupus and 4,644 pregnant people without lupus. The study was conducted in Sweden from 2006 to 2016.³

The link between lupus and gestational diabetes is not entirely understood. Certain steroids to treat lupus may increase the risk for gestational diabetes. Fortunately, studies show that hydroxychloroquine and glucocorticoid are not linked to gestational diabetes or birth defects. These drugs are both commonly used to treat lupus.^2,3

Lupus and pregnancy

People with lupus are more at risk for developing problems like high blood pressure and organ damage. Because of this, people with lupus who are pregnant are at an increased risk for:^1,2

• Miscarriage
• Preterm delivery
• Low-birthweight babies
• Preeclampsia

Preeclampsia is higher-than-normal blood pressure in pregnancy. About 2 in 10 people with lupus get preeclampsia.^1,2

Tips for a healthy pregnancy

If possible, time your pregnancy when lupus activity is low and symptoms are quiet and stable. Discuss family planning with your obstetrician (OB-GYN) and rheumatologist. Ask your doctor about getting antibodies checked before you get pregnant or early in your pregnancy. Certain autoantibodies can increase the risk of premature birth or miscarriage. These test results can help with assessing risk and treatment planning.²

Here are some other tips to consider for a healthy pregnancy:²

• Find an OB-GYN who manages high-risk pregnancies and can work with your rheumatologist.
• Schedule regular appointments with your doctor to monitor symptoms and to get regular lab tests.
• Talk with your doctor about medicines that are safe to take while pregnant.
• Maintain a healthy diet and stay active.

People with lupus should not get pregnant if they:²

• Have severe organ damage – such as kidney failure
• Have very active lupus
• Have autoantibodies
• Require lupus drugs that can cause birth defects, including:
• Mycophenolate mofetil
• Methotrexate
• Cyclophosphamide

For people with lupus, a healthy pregnancy is possible. It just takes a bit more planning and preparation. Talk with your rheumatologist if you are thinking of becoming pregnant.