Pregnancy in rheumatic diseases

Published on January 31, 2019   28 min

A selection of talks on Immunology & Inflammation

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The old dogma that pregnancy is not allowed in rheumatic diseases is now broken.
Rheumatic diseases are more frequent in women of the child-bearing age and fertility is not reduced in these women. So, it's not surprising that the wish for pregnancies is becoming more and more popular. This is true, also, because of the prognosis of the rheumatic diseases has improved in the last years. Moreover, the old contraindication for pregnancy because of the possible transmission of the disease from the mother to the baby in a genetic manner is no more acceptable, since we know that if it's true that systemic rheumatic diseases are genetically determined, they are not usually transmitted in a direct manner to the baby.
Addressing pregnancy in rheumatic diseases, we not only have to take into account the effect of pregnancy on the maternal disease, but we have to also look at the other side of the coin, taking into account the effect of the maternal disease on the pregnancy, and in particular, the effect of the treatment of the mother on the offspring.
Problems for pregnancy in rheumatic diseases are different depending on different diseases. For example, women with rheumatoid arthritis usually, display flares in pregnancy up to 20 percent. So, they're relatively rare. Even though they are rare, there are also risks for complications, which can be found particularly in women with a very active disease. This is true also for the risk for the babies. On the other hand, systemic lupus erythematosus women, as well as other connective tissue diseases, can display flares in pregnancy in up to 50 percent of the cases. The risk for complications is important and includes miscarriages, or pre-eclampsia, prematurity for the mothers, or intrauterine growth retardation, prematurity, and neonatal lupus for babies.