Navigating Pregnancy with Autoimmune Conditions: Understanding the Risks

Celiac.com 03/25/2024 - For women with autoimmune conditions, the journey to motherhood can be fraught with unique challenges and concerns. Autoimmune diseases, which occur when the body's immune system mistakenly attacks its own tissues, are known to affect a significant number of women, particularly during their reproductive years. Understanding the potential impact of these conditions on pregnancy outcomes is essential for both patients and healthcare providers.

A team of researchers recently set out to conduct an umbrella review of autoimmune diseases associated with adverse pregnancy outcomes. Their work sheds some light on the association between autoimmune diseases and adverse pregnancy outcomes, providing potentially valuable insights for individuals navigating pregnancy with conditions such as celiac disease.

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The research team included Megha Singh, Steven Wambua, Siang Ing Lee, Kelvin Okoth, Zhaonan Wang, Fathima Fazla Ahamed Fayaz, Kelly-Ann Eastwood, Catherine Nelson-Piercy, John A. Reynolds, Krishnarajah Nirantharakumar, and Francesca Crowe on behalf of MuM-PreDiCT. They are variously affiliated with the Institute of Applied Health Research, University of Birmingham, Birmingham, UK; the Centre for Public Health, University of Belfast, Belfast, Queen, BT7 1NN, UK; Michael’s Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8EG, UK; the Guy’s and St, Thomas’ NHS Foundation Trust, London, SE1 7EH, UK; and the on behalf of MuM-PreDiCT.

Several Key Associations Identified Between Autoimmune Conditions and Adverse Pregnancy Outcomes

The team's umbrella review, which examined data from 709 primary studies, identified several key associations between autoimmune conditions and adverse pregnancy outcomes. For women with conditions like Sjögren’s syndrome and systemic lupus erythematosus, there was a higher risk of miscarriage. Similarly, pre-eclampsia—a serious pregnancy complication characterized by high blood pressure—was more common in women with type 1 diabetes mellitus and systemic lupus erythematosus.

Other adverse outcomes identified in the review included gestational diabetes, intrauterine growth restriction, preterm birth, low birth weight, and stillbirth. For example, women with type 1 diabetes mellitus were at increased risk of preterm birth and stillbirth, while those with inflammatory bowel disease (IBD) faced a higher risk of gestational diabetes and stillbirth.

These findings underscore the importance of comprehensive preconception and prenatal care for women with autoimmune conditions. Healthcare providers should be vigilant in monitoring and managing these patients throughout their pregnancy journey to mitigate the risks of adverse outcomes. This may include close monitoring of blood sugar levels, blood pressure, and fetal growth, as well as proactive management of maternal health.

Further research is needed to better understand the mechanisms driving the association between autoimmune conditions and adverse pregnancy outcomes. By gaining a deeper understanding of these factors, researchers can develop more effective strategies for optimizing pregnancy outcomes in women with autoimmune diseases.

The team's umbrella review highlights the heightened risk of adverse pregnancy outcomes in women with autoimmune conditions, and emphasizes the need for tailored, multidisciplinary care to support these women throughout their pregnancy journey. With the right support and management, women with autoimmune diseases can have healthy pregnancies and deliver healthy babies.

Read more at BMC Medicine volume 22, Article number: 94 (2024)