Pregnancy and autoimmunity: Maternal treatment and maternal disease influence on pregnancy outcome

Angela Tincani, Chiara Biasini Rebaioli, Micol Frassi, Marco Taglietti, Roberto Gorla, Ilaria Cavazzana, David Faden, Fabrizio Taddei, Andrea Lojacono, Mario Motta, Laura Trepidi, Pierluigi Meroni, Rolando Cimaz, Anna Ghirardello, Andrea Doria, Maria Pia Pisoni, Marina Muscarà, Antonio Brucato

Research output: Contribution to journalArticle

Abstract

If a woman suffers from autoimmune disease (AD), several factors can affect pregnancy or neonatal outcome: repeated spontaneous pregnancy losses (frequently related to antiphospholipid antibodies (aPL)), neonatal lupus with complete congenital heart block (CHB) (linked to transplacental passage of IgG anti Ro/SS-A antibodies) and the disease activity itself that can affect the mother, the pregnancy and fetal outcome. If appropriately managed, the antiphospholipid syndrome (APS) is "one of the few tractable causes of pregnancy losses." A recent case control study, on babies from APS-mothers and healthy mothers, did not show any difference in the occurrence of neonatal complications. There are few data about the long-term outcome of babies born to patients with AD. We recently reported increased occurrence of learning disabilities in children born to aPL positive mothers with systemic lupus erythematosus (SLE). The modern management of pregnancy in patients with AD includes the treatment of disease flares, using drugs effective but safe for fetus. Corticosteroids and some immunosuppressive drugs can be used in pregnancy to control maternal disease. A prolonged fetal exposure to dexamethasone was reported to impair cerebral development, but we recently studied 6 children, born to patients treated with dexamathasone because of CHB, showing a normal intelligence quotient. The last 10-year experience shows that fetal exposure to antimalarial drugs should not be regarded as an important risk factor for gestational nor neonatal complications. However, information about long-term outcome of children exposed to immunosuppressive drugs "in utero" are still lacking and more efforts are needed in this research area.

Original languageEnglish
Pages (from-to)423-428
Number of pages6
JournalAutoimmunity Reviews
Volume4
Issue number7
DOIs
Publication statusPublished - Sep 2005

Keywords

  • Anti Ro/SS-A antibodies
  • Antimalarials
  • Antiphospholipid antibodies
  • Autoimmune disease
  • Corticosteroids
  • Immunosuppressive
  • Pregnancy

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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    Tincani, A., Rebaioli, C. B., Frassi, M., Taglietti, M., Gorla, R., Cavazzana, I., Faden, D., Taddei, F., Lojacono, A., Motta, M., Trepidi, L., Meroni, P., Cimaz, R., Ghirardello, A., Doria, A., Pisoni, M. P., Muscarà, M., & Brucato, A. (2005). Pregnancy and autoimmunity: Maternal treatment and maternal disease influence on pregnancy outcome. Autoimmunity Reviews, 4(7), 423-428. https://doi.org/10.1016/j.autrev.2005.03.001