Autoimmune diseases in pregnancy: their effect on the fetus and newborn

A variegated group of autoimmune disorders tend to occur in women during childbearing years. Autoantibodies, often of IgG type, directed against the mother's (self) antigens has been well characterized in a number of these disorders. Transplacental transfer of IgG autoantibodies has been frequently demonstrated without demonstrable ill effects of offspring of affected mothers. However, transient neonatal autoimmune syndromes have been described in a subset of infants born with circulating autoantibodies. The time course of clinical symptomatology often parallels the presumed half life IgG immunoglobulins. This review details the clinical manifestations of different transient neonatal autoimmune syndromes and describes possible pathogenic mechanisms. Autoimmune disorders reviewed include connective tissue disorders, thyroid autoimmune disorders, myasthenia gravis, idiopathic thrombocytopenic purpura, and other uncommon disorders.