Pregnancy and autoimmune diseases |
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Affiliation: | University of Michigan Schools of Medicine & Public Health, Departments of Internal Medicine, Environmental Health Sciences and Obstetrics and Gynecology, 2800 Plymouth Rd, NCRC B14-G236, Ann Arbor, MI 48109-2800, USA;Department of Obstetrics & Gynecology, University of Michigan, North Campus Research Complex, B014 G236, 2800 Plymouth Rd, SPC 2800, Ann Arbor, MI 48109-2800, USA;Department of Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Drive SPC 5276, Ann Arbor MI 48019-5276, USA |
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Abstract: | Autoimmune diseases (AID) are more prevalent in women than in men, and pregnancy-related factors such as hormonal modulation and fetal microchimerism may influence the future risk of maternal AID. For women with AID, optimizing reproductive health requires a continuum of multidisciplinary care that initiates well before the desire for pregnancy is articulated. Family planning is essential so that pregnancy can be timed when disease is stable and to allow for appropriate medication adjustments. When contraception is used, the choice of method needs to take into consideration underlying disease and laboratory features. For females undergoing gonadotoxic therapy, options for preserving ovarian health and fertility warrant consideration, even among those who are not contemplating future pregnancy. Both maternal and fetal outcomes are optimized with multispecialty care as well as close monitoring during pregnancy and the postpartum period and when treatment regimens compatible with pregnancy are maintained to control underlying disease activity. |
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Keywords: | Autoimmune diseases Pregnancy Preconception care Reproductive health Systemic lupus erythematosus Rheumatoid arthritis |
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