Pregnancy and autoimmune connective tissue diseases |
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| Institution: | 1. Center for Women''s Health Research and Innovation, University of Pittsburgh, Pittsburgh, PA, United States;2. Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, United States;3. Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States;4. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States;5. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States;6. Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States;1. National Advisory Unit on Pregnancy and Rheumatic Diseases, Department of Rheumatology, St. Olavs Hospital, University Hospital of Trondheim, Norway;2. Rheumatology and Clinical Immunology, Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Italy;3. Department of Internal Medicine, Ospedale papa Giovanni XXIII Bergamo, Italy;4. Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Italy;5. Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA;6. Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, NC, USA;7. Université Paris-Descartes, Paris, France;8. AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Paris, France;9. Research Laboratories and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy;10. Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;11. Department of Immunology and Transfusion Medicine, St. Olavs Hospital, Trondheim, Norway;12. Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, CH-3010 Bern, Switzerland;13. Department of Medicine, Centre for Molecular Medicine, Karolinska Universitetssjukhuset, Stockholm, Sweden;14. Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, Spain;15. Women''s Health Academic Centre, St Thomas'' Hospital, London, UK;p. Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel;q. Department of Rheumatology and Clinical Immunology, Ospedale Civile and University of Brescia, Brescia, Italy;r. Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, Bern, Switzerland;s. National Service for Pregnancy and Rheumatic Diseases, Department of Rheumatology, Trondheim University Hospital, Trondheim, Norway;t. Dept of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;u. University Women''s Hospital, Division of Gynaecological Endocrinology and Reproductive Medicine, University of Berne, Berne, Switzerland |
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| Abstract: | Autoimmune connective tissue diseases predominantly affect women and often occur during the reproductive years. Thus, specialized issues in pregnancy planning and management are commonly encountered in this patient population. This chapter provides a current overview of pregnancy as a risk factor for onset of autoimmune disease, considerations related to the course of pregnancy in several autoimmune connective tissue diseases, and disease management and medication issues before pregnancy, during pregnancy, and in the postpartum period. A major theme that has emerged across these inflammatory diseases is that active maternal disease during pregnancy is associated with adverse pregnancy outcomes, and that maternal and fetal health can be optimized when conception is planned during times of inactive disease and through maintaining treatment regimens compatible with pregnancy. |
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| Keywords: | Antiphospholipid antibody syndrome Autoimmunity Myositis Pregnancy Rheumatoid arthritis Scleroderma Sjogren's syndrome Systemic lupus erythematosus |
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