Iijima Shigeo
a Department of Pediatrics , Hamamatsu University School of Medicine , Hamamatsu , Japan.
J Matern Fetal Neonatal Med. 2018 Aug;31(15):2079-2085. doi: 10.1080/14767058.2017.1334048. Epub 2017 Jun 8.
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjögren's syndrome (pSS) tends to result in preterm delivery and low birthweight infants. Moreover, CHB is the most challenging complication for neonates delivered by women with pSS. Pregnant women with rheumatoid arthritis (RA) are at an increased risk for delivering a preterm or SGA neonate. In addition, RA drugs may have adverse effects on the fetus and breast-fed neonate. With dermatomyositis/polymyositis, pregnancies are at increased risk for spontaneous abortion, perinatal death, and preterm delivery. At present, overall neonatal survival rates are good for pregnancies involving systemic sclerosis, despite an increased frequency of premature and SGA neonates. In conclusion, maternal rheumatological diseases require careful monitoring to ensure the best possible management for fetal and neonatal outcomes.
妊娠合并风湿性疾病会对胎儿和/或新生儿产生多种影响。母亲患系统性红斑狼疮（SLE）可能导致早产和/或小于胎龄（SGA）儿出生以及新生儿狼疮（NL）。一些患NL的新生儿会出现先天性心脏传导阻滞（CHB），发病率和死亡率增加，甚至需要安装起搏器。抗磷脂综合征可能与SLE并发，并影响胎儿和/或新生儿结局。涉及原发性干燥综合征（pSS）的妊娠往往导致早产和低体重儿出生。此外，CHB是pSS女性所生新生儿最具挑战性的并发症。患类风湿关节炎（RA）的孕妇分娩早产或SGA新生儿的风险增加。此外，RA药物可能对胎儿和母乳喂养的新生儿有不良影响。对于皮肌炎/多发性肌炎，妊娠发生自然流产、围产期死亡和早产的风险增加。目前，尽管早产和SGA新生儿的发生率增加，但涉及系统性硬化症的妊娠总体新生儿存活率良好。总之，母亲的风湿性疾病需要仔细监测，以确保对胎儿和新生儿结局进行最佳管理。
