Effects of Maternal Autoimmune Disorders on Pregnancy and Fetal Health

Introduction:

Pregnancy is a complex and important physiological process that occurs in the body of a woman, and during this period, the body of the woman will undergo various changes which help in supporting the development and growth of the fetus. In women having an autoimmune disorder, pregnancy can be challenging. When the immune system attacks the own tissues present in the body resulting in chronic inflammation and damage to different organs and systems present in the body, it is called an autoimmune disorder. It can affect the health of pregnancy. Some of the autoimmune disorders commonly seen are rheumatoid arthritis, lupus erythematosus, and multiple sclerosis. The immune system has an important role during the pregnancy period. Any change resulting from the autoimmune disorder can affect the pregnancy.

What Are the Pregnancy Complications Associated With Maternal Autoimmune Disorders?

The complications during the pregnancy which are associated with a maternal autoimmune disorder are different and can vary depending on the specific type of the condition and individual factors. Some of the common complications seen with maternal autoimmune disorder include the following:

• Preterm Birth - Pregnant women with autoimmune disorders like rheumatoid arthritis and systemic lupus erythematosus can have a high chance of delivering the baby prematurely. Immune dysregulation and chronic inflammation can result in early initiation of the labor and can result in early rupture of the membrane. The preterm birth can develop various complications and risks to the fetus, like low birth weight, long-term developmental challenges, and respiratory distress syndrome.

• Fetal Growth Restriction - Fetal growth restriction is the inadequate development of the fetus during the pregnancy period. Some autoimmune disorders can result in fetal growth restriction through various mechanisms like placental insufficiency, reduced placental blood flow or can be due to the presence of specific antibodies like anti-phospholipids. Fetal growth restriction has a high risk of complications like stillbirth, fetal distress, and neonatal morbidity.

• Preeclampsia - Preeclampsia is characterized by hypertension and organ damage, usually seen after the 20th week of the pregnancy period. Pregnant women with autoimmune disorders like systemic lupus erythematosus or anti-phospholipid syndrome have a high chance of developing preeclampsia. It can result in serious complications for both the fetus and the mother, like placental abruption, restricted fetal growth, and maternal organ damage.

• Miscarriage - Autoimmune disorders associated with antiphospholipid antibodies can have a high risk of developing recurrent miscarriages. The antiphospholipid antibodies can affect the clotting of the blood, which leads to reduced placental circulation and can result in miscarriage. So women having autoimmune disorders need close monitoring and treatment like anticoagulant therapy in order to decrease the risk of fetal loss.

• Neonatal Lupus Syndrome - Maternal autoimmune disorders like systemic lupus erythematosus will transfer the autoantibodies through the placenta to the fetus. It results in a condition known as neonatal lupus syndrome, which includes cardiac abnormalities like congenital heart block, skin rashes, and blood abnormalities in the newborn baby. Neonatal lupus syndrome usually resolves after a few months from birth, but it needs medical intervention and monitoring during the pregnancy period and after the delivery of the baby.

What Are the Medication Considerations During Maternal Autoimmune Disorder?

Medication considerations are very important in females with autoimmune disorders who are pregnant or planning to conceive. Balancing the disease to reduce the potential risks to the fetus needs careful evaluation and monitoring.

• Ideally, females having autoimmune disorders have to consult a medical professional before planning to conceive to know the effectiveness and safety of the current medications. Some of the medications are to be adjusted, and some have to be changed to reduce the potential complications and risks during the pregnancy. Changing or stopping the medication without a consultation with a medical specialist can have a significant adverse effect on controlling the disease and can affect the overall health of the patient.

• Medication safety during the maternity period depends on different factors like dosage, type of medication, duration of usage, and the pregnancy stage. Some of the medications are safe during the pregnancy period, but some other medications can result in potential risk.

• During the evaluation of the medication, the potential risk of the autoimmune disorder with the medication will be assessed.

• Depending on the class of medication the safety can vary depending on the specific medication.

• Some medicines used for autoimmune disorders have significant risks during the maternity period.

• The considerations of medications can extend up to the postpartum period while the mothers are breastfeeding. Some medicines are compatible with breastfeeding, while some others need to be discontinued.

How Are Women With Autoimmune Disorders During the Pregnancy Period Managed?

Management of females having autoimmune disorders during the pregnancy period needs comprehensive evaluation and a multidisciplinary approach to treating maternal and fetal health.

• Females having autoimmune disorders need preconception counseling in order to discuss the condition and manage the disease. It helps in knowing the potential risk associated with pregnancy.

• Maternal autoimmune disorder needs a multidisciplinary and collaborative approach to manage and treat the condition.

• Close monitoring of the condition is needed throughout the pregnancy period. It helps in knowing the symptoms. Management can be given accordingly.

• The medicines used to treat the autoimmune disorder have to be adjusted during the pregnancy period. Some medications are safe to use, while some others need to be stopped and replaced with other medications in order to reduce the potential risk.

• Regular care during the prenatal period is important for monitoring the pregnancy and assessing the mother and the fetus. It includes the prenatal visit, laboratory test, and ultrasound examination in order to evaluate the growth of the fetus, function of the placenta, and overall health of both the mother and the fetus.

• Having a healthy lifestyle benefits women having maternal autoimmune disorders.

• Postpartum care is important for supporting the recovery of the mother and managing the autoimmune disorder.

Conclusion:

In conclusion, a maternal autoimmune disorder can have a significant effect on pregnancy and fetal health. It can affect both the developing fetus and the mother. The effects can vary depending on the type of autoimmune disorder, the activity and severity of the disease, and individual factors. It can have a higher risk of adverse pregnancy outcomes like restriction in the growth of the fetus, preeclampsia, preterm birth, and miscarriage. It is associated with immune dysregulation and chronic inflammation, which are the main characteristics of autoimmune disorder.