Pregnancy in autoimmune rheumatic diseases: The importance of counselling for old and new challenges

Laura Andreoli, Chiara Bazzani, Mara Taraborelli, Rossella Reggia, Andrea Lojacono, Antonio Brucato, Pier Luigi Meroni, Angela Tincani

Research output: Contribution to journalArticle

Abstract

Rheumatic diseases can affect women during their childbearing age. Therefore, physicians should introduce a discussion with the patients about pregnancy and its problems. Lupus pregnancies can be successful, even in patients with renal disease, when planned in remission state; the use of low dose aspirin was shown to be an independent predictor of good outcome, so it can be suggested as a preventive measure. Pregnancies in women with Antiphospholipid Syndrome can fail even if properly treated, especially when associated with a systemic autoimmune disease, a history of both thrombosis and pregnancy morbidity, and a triple positivity of antiphospholipid antibody assays. Women with systemic sclerosis have generally a good obstetric outcome, except for an increase rate of preterm deliveries. Severe disease complications were sometimes reported, but their relationship with gestation is not clear yet. Although data on human pregnancy are still preliminary, anti-TNF agents are classified as non teratogens in contrast to methotrexate and leflunomide. So women affected by aggressive chronic arthritis may be treated with anti-TNF in the pre-conceptional period, discontinuing the drug as soon as pregnancy starts. In order to increase maternal compliance and cope with difficult cases, a multidisciplinary team (rheumatologists/internists, obstetricians and neonatologists) should take care of patients during pregnancy.

Original languageEnglish
Pages (from-to)51-54
Number of pages4
JournalAutoimmunity Reviews
Volume10
Issue number1
DOIs
Publication statusPublished - Nov 2010

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Keywords

  • Anti-TNF drugs
  • Antiphospholipid Syndrome
  • Lupus nephritis
  • Pregnancy
  • Rheumatic diseases
  • Systemic sclerosis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Andreoli, L., Bazzani, C., Taraborelli, M., Reggia, R., Lojacono, A., Brucato, A., Meroni, P. L., & Tincani, A. (2010). Pregnancy in autoimmune rheumatic diseases: The importance of counselling for old and new challenges. Autoimmunity Reviews, 10(1), 51-54. https://doi.org/10.1016/j.autrev.2010.08.004