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Risks to the children born to mothers with autoimmune diseases
1Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City 84108, USA. jscott@hsc.utah.edu
Insights
Children born to mothers with connective tissue diseases face risks like fetal growth restriction. While prednisone appears safe, other glucocorticoids and immunosuppressants may pose long-term risks requiring further study.
Area of Science:
- Rheumatology
- Neonatology
- Developmental Pediatrics
Background:
- Connective tissue diseases in pregnant women present unique challenges for fetal development.
- Limited data exist on specific disease effects, but common complications include fetal growth restriction and preterm birth.
Purpose of the Study:
- To review current knowledge on the developmental and long-term effects on children born to mothers with connective tissue diseases.
- To assess the safety of antenatal treatments and identify potential risks to offspring.
Main Methods:
- Literature review of existing studies on maternal connective tissue diseases and pregnancy outcomes.
- Analysis of data on fetal development, birth outcomes, and long-term health of children.
Main Results:
- Fetal growth restriction and preterm birth are common in offspring of mothers with connective tissue diseases.
- Antenatal prednisone use appears safe, with most children developing normally.
- Concerns exist regarding potential decreased growth and abnormal neuronal development with prolonged fetal exposure to other glucocorticoids (dexamethasone, betamethasone).
- Low birth weight is linked to long-term complications like adult-onset hypertension.
- Immunosuppressive agents may increase offspring risk for autoimmune disorders, malignancies, and reproductive issues.
Conclusions:
- While some treatments like prednisone show safety, other medications and the underlying maternal conditions may pose long-term risks to children.
- Further research is essential to fully understand and mitigate unrecognized long-term risks for offspring.
Abstract:
This article reviews current information regarding the development and long-term effects on children born to women with connective tissue diseases. There are few data on specific effects attributed to the underlying maternal disease, but fetal growth restriction and preterm birth are relatively common. Antenatal use of prednisone as treatment for these disorders appears to be safe, and most children have developed normally. However, there is growing concern that prolonged fetal exposure to other glucocorticoids such as dexamethasone or betamethasone may lead to decreased growth and abnormal neuronal development. Low birth weight is reportedly associated with long-term medical complications such as adult-onset hypertension. Evidence also suggests that immunosuppressive agents taken during pregnancy might predispose the progeny to autoimmune disorders, malignancies and reproductive problems. Further research is warranted to determine that there are no unrecognized long-term risks to the offspring of these women.