Pregnancy with Lupus is possible and giving birth to a healthy baby is also possible. However, doctors consider all pregnancies with lupus as "High Risk". High risk" is a term commonly used by obstetricians to indicate that solvable problems may occur and must be anticipated.
Many women are concerned about having a flare during pregnancy, flares most often occur during the first or second trimester, or during the two months immediately after delivery. Most of the flares tend to be mild. The most common symptoms of these flares are arthritis, rashes and fatigue. Approximately 33 percent of lupus patients will have a decrease in platelet count during pregnancy, and about 20 percent will have an increase in or new occurrence of protein in the urine.
However, Lupus nephritis is one of the most serious manifestations of SLE. Histological evidence of lupus nephritis is present in most patients with SLE, even if they do not have clinical manifestations of renal disease. The symptoms are generally related to hypertension, proteinuria, and renal failure.
But, with the advent of more aggressive immunosuppressive and supportive therapy, renal and patient survival rates are improving.
The problem is that doctors usually advise their patients with Lupus Nephritis to avoid pregnancy because it may aggravate renal disease, especially in the presence of active lupus nephritis, nephrotic syndrome, severe hypertension, or serum creatinine levels elevated to more than 2 mg/dL.
Here are some statistics that I found:
" Patients with lupus nephritis have a 50-60% chance of renal flare during pregnancy if they conceive during active disease. Patients with well-controlled SLE who conceive after a 3- to 6-month period of remission have a 7-10% chance of renal flare. Pregnant patients with lupus nephritis are prone to preeclampsia. Preexisting hypertension and antiphospholipid antibody syndrome are the 2 most common predisposing factors to preeclampsia. Severe flares during pregnancy may cause acute renal failure and maternal and fetal death."
It is recommended that the Obstetrician and the Rheumatologist closely monitor pregnant patients with SLE, aggressively treat exacerbations, and carefully avoid administering teratogenic drugs (Drugs which cause malformations to the baby are known as teratogens. Other drugs that are dangerous may still cause neurological and behavioral problems without causing malformed anatomy in the baby. A teratogen is an agent that can disturb the development of the embryo or fetus. Teratogens can halt the pregnancy or, alternatively, permit the pregnancy to proceed but produce a congenital malformation (a birth defect). Classes of known teratogens include radiation, maternal infections, chemicals, and drugs).
I hope that I've answered some of your questions
Peace and Blessings