Antibodies as risk factors for adverse maternal and foetal outcomes

Abstract

A variety of autoantibodies associated with Rheumatic diseases have been associated with adverse maternal and foetal pregnancy outcomes. For instance, pregnancy morbidity in women with antiphospholipid antibodies (aPL) include unexplained consecutive recurrent 1st trimester pregnancy loss (<10 weeks’ gestation), any 2nd or 3rd trimester pregnancy loss, premature birth <34 weeks due to conditions associated with placental insufficiency including severe pre-eclampsia, eclampsia, placental abruption, foetal growth restriction, and intrauterine death. Moreover, antibodies against extractable nuclear antigens (ENA), such as anti-Ro/SSA and/or anti-La/SSB antibodies, have been associated with the development of congenital heart block (CHB) and neonatal lupus in the offspring. More recently, antibodies against U1-ribonucleoprotein (U1RNP) are suggested to be associated with adverse foetal and maternal pregnancy outcomes. In general, women with rheumatological diseases should receive pregnancy counselling. Moreover, women require follow up during pregnancy in order to maximize their chance to have a successful pregnancy.