[Pregnancy associated with connective tissue disease].

Area of Science:

• Rheumatology
• Obstetrics
• Neonatology

Context:

• Connective tissue diseases (CTDs) often affect women during reproductive years, raising complex questions about pregnancy impacts.
• Historically, the interplay between CTDs and pregnancy outcomes, including fetal development, has been poorly understood.
• Advancements in understanding CTD pathogenesis and antibody mechanisms are improving management strategies.

Purpose:

• To review the impact of CTDs on pregnancy and fetal development.
• To discuss the management of CTDs during pregnancy, emphasizing multidisciplinary care.
• To highlight current understanding of risks and improved outcomes in pregnant patients with CTDs.

Summary:

• Pregnancy in women with CTDs like systemic lupus erythematosus and scleroderma presents unique challenges but outcomes are improving.
• Multicenter studies have debunked some myths about the fatal nature of pregnancy with certain CTDs.
• Risk factors for adverse outcomes include active lupus nephritis, hypertension, antiphospholipid antibodies, and prior miscarriages.

Impact:

• Improved disease control and reduced adverse pregnancy outcomes are achievable with current medical knowledge.
• Careful pregnancy planning and collaboration among rheumatologists, obstetricians, and neonatologists are crucial.
• While risks remain, pregnancy is now only contraindicated in a small subset of high-risk CTD patients.