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Autoimmune disease in pregnancy.
1Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio.
The Medical Clinics of North America
|May 1, 1989
Summary
Autoimmune disorders, including systemic lupus erythematosus (SLE), can negatively impact pregnancy outcomes, leading to excessive pregnancy loss and premature birth. Managing maternal disease activity is key to improving fetal health.
Area of Science:
- Reproductive immunology
- Maternal-fetal medicine
- Rheumatology
Background:
- Autoimmunity, including systemic lupus erythematosus (SLE) and autoantibodies, is linked to adverse reproductive outcomes.
- While fertility is often preserved, specific autoimmune conditions pose risks during pregnancy.
Purpose of the Study:
- To evaluate the impact of pregnancy on the course of autoimmune disorders like SLE.
- To assess the effects of SLE and autoantibodies on pregnancy and fetal outcomes.
- To guide the management of pregnancies in women with autoimmune conditions.
Main Methods:
- Review of recent data on pregnant women with SLE.
- Correlation analysis between maternal disease activity, autoantibodies, and fetal complications.
- Assessment of risks associated with maternal drug therapy versus maternal disease effects.
Main Results:
- Pregnancy does not typically alter the overall course of SLE in affected women.
- Adverse fetal outcomes, including pregnancy wastage and poor fetal growth, are common.
- Fetal complications correlate significantly with maternal disease activity and specific autoantibodies.
Conclusions:
- The primary impact of SLE and autoimmunity during pregnancy is on adverse fetal outcomes, not maternal disease progression.
- Maintaining maternal disease quiescence is crucial for optimizing fetal growth and development.
- The risks of maternal autoimmune disease to fetal development outweigh potential risks from necessary drug therapies.