Maternal and Perinatal Outcomes of Pregnancy in Women With Autoimmune Disorder

Abstract

Pregnancy with an autoimmune disorder is faced with several risks for mother and fetus. The aim of the present study is to analyze the course and outcome of pregnancy in women with autoimmune disorders (AIDs). MethodsA retrospective cohort study was conducted at a tertiary care teaching hospital. The hospital records of 153 pregnancies with autoimmune disorders and 1095 low-risk pregnant women who served as controls were reviewed. An adverse perinatal outcome was defined as the presence of any obstetric complications, including preeclampsia, eclampsia, abruption, antepartum hemorrhage (APH), prematurity, fetal growth restriction (FGR), intrauterine death (IUD), intrapartum event, mode of delivery, birth weight, neonatal intensive care unit (NICU) stay, or disease-specific neonatal complications. For all statistical tests with twotailed probability, p<0.05 was considered statistically significant. ResultsA high incidence of adverse perinatal outcomes was observed in all women with AIDs when compared with age-matched controls. The highest incidence of adverse perinatal outcomes was observed in women with Takayasu's arteritis. The incidence of abortions was more in women with antiphospholipid antibody syndrome (APS) and Grave's disease (22.2% and 33.3%, respectively). The incidence of prematurity, fetal growth restriction (FGR), and low birth weight were highest in women with systemic lupus erythematosus (SLE). Pregnancy with myasthenia gravis and rheumatoid arthritis did not have any significant adverse impact on pregnancy outcomes. ConclusionWe found a strong association between autoimmune disorders and obstetric complications. The multidisciplinary team approach and pre-pregnancy optimization of the disease improve maternal and fetal outcomes.

Effects of Astragalus membranaceus on systemic lupus erythematosus in a mouse model of pregnancy

“…Pregnancy with SLE is a high‐risk pregnancy 4 . Pregnancy will increase the risk of recurrence of SLE 5 . The disease itself will also increase the possibility of adverse pregnancy outcomes for pregnant women, mainly including pre‐eclampsia, hypertension of pregnancy, premature birth, fetal loss, fetal intrauterine growth restriction, neonatal lupus 6…”

“…4 Pregnancy will increase the risk of recurrence of SLE. 5 The disease itself will also increase the possibility of adverse pregnancy outcomes for pregnant women, mainly including pre-eclampsia, hypertension of pregnancy, premature birth, fetal loss, fetal intrauterine growth restriction, neonatal lupus. 6 Helper T cell 17 (Th17) is a CD4+ T cell subgroup characterized by the production of proinflammatory factor interleukin (IL)-17.…”