Váncsa A, Ponyi A, Constantin T, Zeher M, Dankó K
Division of Clinical Immunology, Third Department of Internal Medicine, Institute of Medicine, University of Debrecen, Hungary.
Rheumatol Int. 2007 Mar;27(5):435-9. doi: 10.1007/s00296-006-0239-8.
The aim of our study was to assess the prevalence and outcome of pregnancy in idiopathic inflammatory myopathy patients who became pregnant after the onset of the disease. Female idiopathic inflammatory myopathy patients (173) were included in our study. The patients' charts and clinical data were retrospectively analyzed. One hundred and four female idiopathic inflammatory myopathy patients had 186 pregnancies, but only nine of these patients (4 polymyositis-PM, 5 dermatomyositis-DM) became pregnant after the onset of the disease. Nine patients with pregnancies after the disease onset had 14 gravidities. Six pregnancies resulted in normal deliveries, two ended in prematurity, six ended in abortions (two induced abortions). Regarding the four patients (3 PM, 1 DM) with active disease at the time of pregnancy, two pregnancies ended in prematurity, four ended in spontaneous abortion and one healthy baby delivered. The other five patients (2 PM, 3 DM) with the disease in remission had uneventful pregnancies and healthy babies were delivered. Treatment was not required during pregnancy in case of two dermatomyositis patients with long lasting remission. New onset dermatomyositis developed in one patient in her pregnancy's third trimester. The mean weight of newborns in the active myositis cases was 2,193 (1,680-2,700) g; while in patients with remission was 3,167 (2,800-3,800) g. The active maternal disease in idiopathic inflammatory myopathy (IIM) might result intrauterin retardation and death. Disease activity in active and new-onset cases could be controlled by increasing the dose of corticosteroid.
我们研究的目的是评估疾病发作后怀孕的特发性炎性肌病患者的妊娠患病率及结局。173例女性特发性炎性肌病患者纳入我们的研究。对患者的病历和临床资料进行回顾性分析。104例女性特发性炎性肌病患者有186次妊娠,但其中只有9例患者(4例多发性肌炎 - PM,5例皮肌炎 - DM)在疾病发作后怀孕。9例疾病发作后怀孕的患者有14次妊娠。6次妊娠顺产,2次早产,6次流产(2次人工流产)。对于妊娠时疾病活动的4例患者(3例PM,1例DM),2次妊娠早产,4次自然流产,1例分娩出健康婴儿。其他5例疾病缓解的患者(2例PM,3例DM)妊娠过程顺利,分娩出健康婴儿。2例长期缓解的皮肌炎患者在孕期无需治疗。1例患者在妊娠晚期新发皮肌炎。活动性肌炎病例中新生儿的平均体重为2193(1680 - 2700)g;而缓解期患者的新生儿平均体重为3167(2800 - 3800)g。特发性炎性肌病(IIM)患者的活动性母体疾病可能导致胎儿宫内发育迟缓及死亡。活动性和新发病例的疾病活动可通过增加皮质类固醇剂量来控制。