Tincani A, Bompane D, Danieli E, Doria A
Rheumatology and Clinical Immunology, Brescia Hospital and University, Italy.
Lupus. 2006;15(3):156-60. doi: 10.1191/0961203306lu2279rr.
Autoimmune diseases (AD) occur frequently in women during their childbearing years and may influence pregnancy outcome and neonatal health. Patients with systemic lupus erythematosus (SLE) can experience a disease flare-up during pregnancy with potential negative effects on the product of conceptus, especially if the disease is active. Recurrent pregnancy loss is now considered as a treatable clinical condition associated with the presence of circulating antiphospholipid antibodies (aPL). The neonatal lupus syndromes (NLS), caused by the transplacental passage of maternal IgG anti-Ro/SS-A and anti-La/SS-B antibodies to the fetus, carry significant morbidity and mortality in case of cardiac manifestations. Immunosuppressive agents are often administered during pregnancy in order to control maternal disease and to ensure a better pregnancy outcome. Nowadays, owing to our increasing knowledge of the disease pathophysiological mechanisms and the development of combined medical-obstetric clinics, pregnancy outcome in patients with AD has notably improved.
自身免疫性疾病(AD)在育龄女性中频繁发生,可能会影响妊娠结局和新生儿健康。系统性红斑狼疮(SLE)患者在孕期可能会出现疾病复发,对胎儿产生潜在的负面影响,尤其是在疾病活动期。复发性流产现在被认为是一种与循环抗磷脂抗体(aPL)存在相关的可治疗临床病症。由母体IgG抗Ro/SS - A和抗La/SS - B抗体经胎盘传递给胎儿所引起的新生儿狼疮综合征(NLS),若出现心脏表现则具有显著的发病率和死亡率。为了控制母体疾病并确保更好的妊娠结局,孕期常使用免疫抑制剂。如今,由于我们对疾病病理生理机制的认识不断增加以及联合医疗产科诊所的发展,AD患者的妊娠结局已显著改善。