Abstract
ObjectivePregnancy 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 two-tailed 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.
Highlights
Autoimmune disorders (AIDs) are rare and six to 10 times more common in women than men [1]
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
A high incidence of adverse perinatal outcomes was observed in all women with AIDs when compared with age-matched controls
Summary
Autoimmune disorders (AIDs) are rare and six to 10 times more common in women than men [1]. They are characterized by self-reactivity of the immune system, deposition of immune complexes in target organs, and the resultant diverse clinical manifestations. The onset of the disease usually occurs in the reproductive age group and, it is not unusual for obstetricians to come across these women during their pregnancy. Women with some of these disorders were advised against pregnancy but nowadays with the availability of better care, an optimum outcome can be anticipated [1]. Due to the risk of disease exacerbations and consequent adverse maternal and fetal outcomes, pregnancy is considered a high-risk condition for these patients
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