pregnancy & babyGuide

You Can Have a Healthy Pregnancy With a Chronic Health Condition

If you have a chronic condition such as diabetes, thyroid disease, hypertension, or asthma and take medication regularly, you may have concerns about pregnancy. Having a chronic condition does not necessarily prevent you from having a healthy pregnancy. The key is to keep your condition well controlled and review your medications with your healthcare provider before pregnancy whenever possible.

Should I stop my regular medications once I’m pregnant?

Not necessarily. Some medications need to be changed or stopped during pregnancy, but stopping treatment on your own can cause your condition to worsen and may put both you and your baby at greater risk.

For example, suddenly stopping antiseizure medication in someone with epilepsy can increase the risk of seizures. If you are planning a pregnancy, talk with your specialist about whether to continue your current medication, adjust the dose, or switch to another treatment. If you are already pregnant, do not stop your medication without medical advice.

If you have diabetes or high blood pressure

If you had diabetes before pregnancy, good blood glucose control before conception and during early pregnancy is especially important because poorly controlled blood glucose can increase the risk of birth defects and other pregnancy complications. Discuss your glucose targets, medications, and folic acid supplementation with your healthcare team when planning pregnancy.

Insulin is widely used to manage diabetes during pregnancy. Depending on your condition and the medication you take, other diabetes medicines may be continued or changed. Do not stop or switch your medication on your own.

If you have chronic hypertension, review your medication before pregnancy. ACE inhibitors and angiotensin II receptor blockers (ARBs) should generally be avoided during pregnancy, so your healthcare provider may recommend an alternative. If you took one before realizing you were pregnant, contact your healthcare provider rather than making changes on your own.

Most pregnant patients taking statins for high cholesterol are advised to stop them during pregnancy, although exceptions may be considered for people at very high cardiovascular risk. This decision should be made with your specialist.

If you have an autoimmune disease

If you have rheumatoid arthritis or systemic lupus erythematosus (SLE), it is best to plan pregnancy when your disease is well controlled. Active disease can increase the risk of pregnancy complications.

Your medications should be reviewed before pregnancy. Some treatments can be continued during pregnancy, while others, such as methotrexate, must be avoided. Work with your rheumatologist and obstetric team to find a treatment plan that keeps your disease controlled while minimizing risks to the pregnancy.

If you have epilepsy or a mental health condition

If you have epilepsy, review the type and dose of your antiseizure medication before pregnancy and discuss folic acid supplementation with your healthcare provider. Do not suddenly stop antiseizure medication, as this can increase the risk of seizures.

People with depression, bipolar disorder, schizophrenia, and other mental health conditions can also plan healthy pregnancies. Psychiatric medications should not automatically be stopped or switched. Treatment decisions should balance the risks and benefits of medication with the importance of keeping the condition stable.

If you have thyroid disease

Whether you have hypothyroidism or hyperthyroidism, keeping thyroid hormone levels well controlled before and during pregnancy is important.

Levothyroxine, used to treat hypothyroidism, can be taken during pregnancy, although the dose may need to be adjusted.

If antithyroid medication is needed for hyperthyroidism, the preferred medication may change during pregnancy. Propylthiouracil (PTU) is generally preferred during the first trimester, while methimazole may be considered later in pregnancy depending on your situation. Work with your endocrinologist to adjust treatment appropriately.

Talk to your healthcare team before pregnancy

Having a chronic health condition does not mean you should stop all of your medications. Keeping your condition stable is an important part of a healthy pregnancy. Ideally, talk with your specialist and obstetric team before conception to review your condition, medications, and pregnancy plan.