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A positive pregnancy test result can bring many feelings when you’re living with Sjögren’s disease (formerly called Sjögren’s syndrome). Having questions about medication safety or your baby’s well-being is completely understandable, but current evidence is reassuring. With thoughtful planning and a supportive healthcare team, most people with Sjögren’s can expect healthy pregnancy outcomes.
Sjögren’s is an autoimmune disease. In autoimmune diseases, the immune system mistakenly attacks healthy parts of the body. In Sjögren’s, the glands that make moisture are affected. This can cause dry eyes, dry mouth, fatigue (extreme tiredness that doesn’t improve with rest), and joint pain.
Pregnancy can change how Sjögren’s affects your body. Some people notice fewer symptoms during pregnancy, while others find that dryness or fatigue stays the same or shifts.
This article explores how Sjögren’s may affect pregnancy, what conditions to be aware of, how to manage each stage, and practical steps to support both your health and your baby’s development.
During pregnancy, your body works to protect the growing baby, who has a unique set of genes. To avoid treating the baby as something “foreign,” your immune system naturally shifts into a state called immune tolerance. This means your immune system becomes less reactive than usual, which helps prevent it from mistakenly attacking the baby.
For some people with autoimmune diseases, this change can lead to fewer symptoms for a while. However, others with Sjögren’s may find that fatigue or dryness stays the same or changes during pregnancy.
Knowing that your body is adjusting to support the pregnancy can help you understand why symptoms may change.
Sjögren’s brings special considerations for your well-being alongside the usual changes of pregnancy. Knowing what to expect can help you feel more prepared.
Sjögren’s disease flares are a common challenge during pregnancy. You might notice more fatigue, joint pain, or worsening dryness, which can be tricky to identify because they often look and feel like common pregnancy discomforts. This makes regular visits with your rheumatologist essential for monitoring your health.
Research shows that people with Sjögren’s may have a higher risk of preeclampsia. This condition causes hypertension (high blood pressure) and protein in the urine. To help keep you safe, your healthcare team will closely check your blood pressure at every prenatal visit.
Managing Sjögren’s during pregnancy means balancing inflammation control with the safety of your developing baby. Medications that are generally considered safe to use during pregnancy to treat symptoms or prevent flares include:
Meanwhile, the following medications are known to cause birth defects or don’t have enough safety data, and they generally should be stopped before becoming pregnant:
Never stop or start medication without talking to your doctor first. Even medications that are considered safe may need dose changes or added supplements. Others may need to be stopped months ahead of time so they can fully leave your body. Your healthcare team can help you weigh the risks and plan the safest timeline for you and your baby.
Because Sjögren’s can influence certain aspects of your baby’s development, your pregnancy will include additional monitoring to support your baby’s health.
Most people with Sjögren’s have anti-SSA (also called anti-Ro antibodies), anti-SSB (also called anti-La antibodies), or both. These are immune proteins that can cross the placenta during pregnancy. Most people who have these autoantibodies still have healthy babies.
However, doctors usually monitor more closely for two rare conditions: congenital heart block and neonatal lupus. A simple blood test can confirm whether you have these antibodies. The results help your doctors plan how to monitor your pregnancy.
Autoimmune congenital heart block affects about 2 percent of babies in the first pregnancy when the mother carries anti-SSA or anti-SSB antibodies. If you test positive for these antibodies, your doctors will use specialized ultrasounds called fetal echocardiograms to monitor your baby’s heart development, typically between 16 and 26 weeks. This close monitoring allows your care team to act quickly if anything changes.
Neonatal lupus is a rare condition that can happen when the pregnant parent’s antibodies cross the placenta. It often causes short-term symptoms, like a rash that goes away within six to 12 months. Most symptoms fade as the antibodies leave the baby’s body.
In rare cases, neonatal lupus can cause congenital heart block, a serious heart rhythm problem that can be permanent. That’s why doctors may do frequent fetal echocardiograms during pregnancy.
For most babies with neonatal lupus, the long-term outlook is very good.
Sjögren’s disease may affect your baby’s growth or birth timing. Regular ultrasounds help make sure your baby is developing well and receiving enough blood flow.
Sjögren’s is not passed directly from parent to child. While your baby might have a slightly higher chance of getting it than others, it’s not guaranteed. Most children born to parents with Sjögren’s grow up healthy and never get the disease.
Once you understand the key risks and how they’re managed, it helps to look at what the pregnancy journey usually involves from start to finish.
Having Sjögren’s typically does not make it harder to get pregnant. Use reliable birth control until you decide you’re ready to get pregnant.
Try to keep your disease activity low and stable for three to six months before trying to get pregnant. During preconception visits with your rheumatologist and obstetrician, they will review your medications and adjust them to prepare your body for a healthy pregnancy, order antibody testing, and confirm that your prenatal vitamins include folic acid.
During the first trimester, you’ll meet with your care team, review your treatment plan, and confirm your due date. Your specialists will outline your monitoring schedule based on your antibody status and overall health.
The second trimester brings the most intensive monitoring if you have anti-SSA or anti-SSB antibodies. Your doctors will perform regular fetal heart scans to allow your team to find any changes early.
As you enter the third trimester, monitoring focuses on checking for preeclampsia, tracking your baby’s growth, and planning for delivery. You’ll continue to have regular ultrasounds as your due date gets closer.
Most people with Sjögren’s have vaginal births without complications related to the disease. Cesarean deliveries are performed for standard medical reasons, though they may be needed more often because Sjögren’s can increase the risk of pregnancy complications. If you’ve been taking long-term corticosteroids, your care team may give you a higher dose of steroids during labor to help your body handle the stress of childbirth.
Some people have disease flares in the weeks after delivery as pregnancy-related immune changes fade. Watch for increasing joint pain, fatigue, or other symptoms, and stay in close contact with your rheumatologist.
Breastfeeding is encouraged for many people with Sjögren’s, and you may have more options for medications than you did during pregnancy. For example, ibuprofen is generally considered compatible with breastfeeding, though you should always review your specific plan with your doctor before making any changes.
Because dryness can make breastfeeding more difficult, staying well-hydrated and working with a lactation consultant can help make the process more comfortable.
If you have anti-SSA or anti-SSB antibodies, your pediatrician will check your baby’s heart rhythm shortly after birth. They may also look for a rash or check blood counts. Most babies do not need any treatment and do very well.
A pregnancy that requires extra monitoring can trigger mixed emotions. Talking with a mental health professional familiar with chronic illness or joining a support group can provide connection and perspective.
Caring for your emotional health supports your overall well-being and helps you move through pregnancy with more confidence.
Schedule a preconception visit with your rheumatologist and ask for antibody testing if you haven’t had it done recently. This appointment sets everything else in motion.
Track your symptoms in a simple notebook or phone app. Recording your energy levels, pain, and dryness gives you useful information to bring to each visit.
Although the process may include extra check-ins and precautions, you won’t be doing it alone. Rely on your healthcare team and support system, and keep in mind that most people with Sjögren’s disease have smooth pregnancies and healthy babies.
On MySjögrensTeam, people share their experiences with Sjögren’s, get advice, and find support from others who understand.
Has your Sjögren’s diagnosis changed how you think about starting or growing a family? Let others know in the comments below.
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