Pregnancy and Autoimmune Disease.
Journal
Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967
Informations de publication
Date de publication:
04 03 2022
04 03 2022
Historique:
received:
19
04
2021
revised:
19
04
2021
accepted:
01
10
2021
pubmed:
8
12
2021
medline:
12
5
2022
entrez:
7
12
2021
Statut:
ppublish
Résumé
Pregnancies in women with chronic disease are on the rise. This pertains to autoimmune diseases in particular since these tend to affect women of childbearing age. The interaction between pregnancy and autoimmune disease may increase the risk of maternal, fetal, and obstetric complications; additional care may be required. This review is based on a selective literature search in PubMed (2015-2020). In women with autoimmune diseases, the course of pregnancy is highly variable. Some autoimmune diseases tend to improve during pregnancy and do not to result in any serious obstetric complications. Others may worsen during pregnancy, with deterioration of the maternal condition as well as obstetric and perinatal complications. In systemic lupus erythematosus and myasthenia gravis, placental transfer of specific autoantibodies may cause fetal or neonatal disease. The care of pregnant women with chronic diseases requires collaboration between specialists of the pertinent levels of care. A stable course of disease before conception, close interdisciplinary care, and pregnancy-compatible medication contribute to a reduction in maternal and perinatal complications.
Sections du résumé
BACKGROUND
Pregnancies in women with chronic disease are on the rise. This pertains to autoimmune diseases in particular since these tend to affect women of childbearing age. The interaction between pregnancy and autoimmune disease may increase the risk of maternal, fetal, and obstetric complications; additional care may be required.
METHODS
This review is based on a selective literature search in PubMed (2015-2020).
RESULTS
In women with autoimmune diseases, the course of pregnancy is highly variable. Some autoimmune diseases tend to improve during pregnancy and do not to result in any serious obstetric complications. Others may worsen during pregnancy, with deterioration of the maternal condition as well as obstetric and perinatal complications. In systemic lupus erythematosus and myasthenia gravis, placental transfer of specific autoantibodies may cause fetal or neonatal disease.
CONCLUSION
The care of pregnant women with chronic diseases requires collaboration between specialists of the pertinent levels of care. A stable course of disease before conception, close interdisciplinary care, and pregnancy-compatible medication contribute to a reduction in maternal and perinatal complications.
Identifiants
pubmed: 34874264
pii: arztebl.m2021.0353
doi: 10.3238/arztebl.m2021.0353
pmc: PMC9201458
doi:
pii:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
145-156Références
Muscle Nerve. 2020 Dec;62(6):664-672
pubmed: 32929722
Congenit Heart Dis. 2012 Jul-Aug;7(4):349-60
pubmed: 22494551
Prenat Diagn. 2019 Feb;39(3):219-231
pubmed: 30578734
Ultrasound Obstet Gynecol. 2019 Jul;54(1):87-95
pubmed: 30620419
Acta Obstet Gynecol Scand. 2014 Mar;93(3):302-7
pubmed: 24359405
Circulation. 2004 Sep 21;110(12):1542-8
pubmed: 15353508
Ann Rheum Dis. 2016 Jun;75(6):1161-5
pubmed: 26835701
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Apr;62(4):494-515
pubmed: 30899964
J Rheumatol. 2019 Mar;46(3):245-250
pubmed: 30385703
Aliment Pharmacol Ther. 2020 Nov;52(9):1480-1490
pubmed: 33095502
Am J Obstet Gynecol. 2021 Jan;224(1):95.e1-95.e12
pubmed: 32687818
Br J Haematol. 2020 Mar;188(6):819-830
pubmed: 31578718
Inflamm Bowel Dis. 2017 May;23(5):712-720
pubmed: 28426452
Neurol Neuroimmunol Neuroinflamm. 2014 Dec 23;2(1):e57
pubmed: 25566546
Neurol Neuroimmunol Neuroinflamm. 2020 Apr 23;7(4):
pubmed: 32327455
Nat Rev Nephrol. 2015 Mar;11(3):135-49
pubmed: 25599618
Circ Arrhythm Electrophysiol. 2020 Oct;13(10):e008686
pubmed: 32907357
Ann Rheum Dis. 2018 Feb;77(2):264-269
pubmed: 29092851
Clin Nutr. 2017 Apr;36(2):321-347
pubmed: 28131521
Circulation. 2014 May 6;129(18):1804-12
pubmed: 24589851
Eur J Neurol. 2018 Dec;25(12):1402-1409
pubmed: 30133097
N Engl J Med. 2017 Aug 17;377(7):613-622
pubmed: 28657417
Ultrasound Obstet Gynecol. 2017 Jun;49(6):751-755
pubmed: 28067011
Front Neurol. 2020 Jun 12;11:554
pubmed: 32595594
Birth Defects Res. 2019 May 1;111(8):380-388
pubmed: 30821931
BMC Pregnancy Childbirth. 2014 Feb 19;14:75
pubmed: 24552439
Cochrane Database Syst Rev. 2019 Oct 30;2019(10):
pubmed: 31684684
Fetal Diagn Ther. 2021;48(3):183-188
pubmed: 33592603
Arch Gynecol Obstet. 2021 Feb;303(2):435-441
pubmed: 32880707
J Crohns Colitis. 2013 Jul;7(6):e206-13
pubmed: 23040449
Inflamm Bowel Dis. 2020 Nov 19;26(12):1926-1932
pubmed: 31895410
Nat Rev Gastroenterol Hepatol. 2011 Oct 04;8(11):610-34
pubmed: 21970872
Ann Gastroenterol. 2018 Jan-Feb;31(1):14-23
pubmed: 29333063
Ther Adv Neurol Disord. 2020 Jul 1;13:1756286420936166
pubmed: 32655689
Acta Obstet Gynecol Scand. 2016 Nov;95(11):1295-1304
pubmed: 27560844
Dig Dis Sci. 2015 Sep;60(9):2750-61
pubmed: 26070523
BMJ. 2011 Oct 18;343:d5931
pubmed: 22010128
Am J Obstet Gynecol. 2018 Jul;219(1):62-74
pubmed: 29630886
Sci Rep. 2017 Oct 31;7(1):14426
pubmed: 29089519
Nat Rev Immunol. 2017 Aug;17(8):469-482
pubmed: 28627518
Immunol Med. 2021 Sep;44(3):204-210
pubmed: 33417532
Ann Intern Med. 2015 Aug 4;163(3):153-63
pubmed: 26098843
Ultrasound Obstet Gynecol. 2010 Nov;36(5):561-6
pubmed: 20069676
J Neurol. 2010 Apr;257(4):580-3
pubmed: 19936821
Ultrasound Obstet Gynecol. 2020 Aug;56(2):298-312
pubmed: 32738107
Scand J Immunol. 2010 Sep;72(3):235-41
pubmed: 20696021
Pediatr Cardiol. 2013 Oct;34(7):1535-55
pubmed: 23963188
J Autoimmun. 2017 May;79:17-27
pubmed: 28256367
Lupus. 2019 May;28(6):722-730
pubmed: 30971164
Am J Gastroenterol. 2006 Jul;101(7):1539-45
pubmed: 16863558
J Clin Gastroenterol. 2019 Sep;53(8):574-581
pubmed: 31306343
Inflamm Bowel Dis. 2019 Mar 14;25(4):627-641
pubmed: 30821832
Gastroenterology. 2021 Mar;160(4):1131-1139
pubmed: 33227283
Transl Psychiatry. 2021 Jan 21;11(1):71
pubmed: 33479207
Obstet Gynecol. 2020 Nov;136(5):892-901
pubmed: 33030867
Geburtshilfe Frauenheilkd. 2017 Nov;77(11):1157-1173
pubmed: 29375144
Gastroenterology. 2017 Feb;152(3):554-563.e9
pubmed: 27773807
Neurol Neuroimmunol Neuroinflamm. 2020 Dec 17;8(1):
pubmed: 33334856
Prenat Diagn. 2017 Apr;37(4):375-382
pubmed: 28177533
Dig Dis Sci. 2021 Apr;66(4):1189-1194
pubmed: 32356256
Ann Rheum Dis. 2019 Oct;78(10):1296-1304
pubmed: 31092409
Joint Bone Spine. 2018 Dec;85(6):663-668
pubmed: 29631068
Semin Arthritis Rheum. 2019 Oct;49(2):236-240
pubmed: 30992155
Nat Genet. 2019 May;51(5):804-814
pubmed: 31043758
Gut. 2019 Dec;68(Suppl 3):s1-s106
pubmed: 31562236
Ultraschall Med. 2008 Apr;29(2):197-200
pubmed: 18382967
JAMA Netw Open. 2019 Sep 4;2(9):e1910915
pubmed: 31539074
J Crohns Colitis. 2015 Feb;9(2):107-24
pubmed: 25602023
Nat Rev Neurol. 2020 Mar;16(3):154-170
pubmed: 32080393
J Crohns Colitis. 2020 Oct 5;14(10):1405-1412
pubmed: 32343768
J Am Coll Cardiol. 2018 Oct 16;72(16):1940-1951
pubmed: 30309472
Ultraschall Med. 2012 Dec;33(6):593-6
pubmed: 23147272
Ann Rheum Dis. 2019 May;78(5):696-703
pubmed: 30808622
Ultraschall Med. 2019 Apr;40(2):176-193
pubmed: 30001568
J Perinat Med. 2020 Oct 25;48(8):793-798
pubmed: 32739906
Diagnostics (Basel). 2020 Aug 12;10(8):
pubmed: 32806663
Front Cardiovasc Med. 2019 Feb 28;6:11
pubmed: 30873413
Obstet Gynecol. 2018 Jul;132(1):e44-e52
pubmed: 29939940
Arthritis Rheumatol. 2020 Apr;72(4):529-556
pubmed: 32090480
Ther Adv Neurol Disord. 2020 Aug 25;13:1756286420949808
pubmed: 32922516
Lancet Neurol. 2006 Nov;5(11):932-6
pubmed: 17052660
Ultrasound Obstet Gynecol. 2021 Sep;58(3):360-368
pubmed: 33794058
Lancet. 2018 Dec 23;390(10114):2769-2778
pubmed: 29050646
Prenat Diagn. 2020 Aug;40(9):1066-1076
pubmed: 32282083
J Am Coll Cardiol. 2020 Jul 21;76(3):303-305
pubmed: 32674793