妊娠与自身免疫性疾病。
Pregnancy and Autoimmune Disease.
机构信息
Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn; Department of Rheumatology and Hiller, Forschungszentrum University Hospital Düsseldorf; Katholisches Klinikum Bochum, Neurology Clinic,Clinic of Ruhr-Universität Bochum; Department of Medicine II, Division of Gastroenterology and Endocrinology, University Medical Center Rostock; Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn.
出版信息
Dtsch Arztebl Int. 2022 Mar 4;119(9):145-156. doi: 10.3238/arztebl.m2021.0353.
BACKGROUND
Pregnancies in women with chronic disease are on the rise. This pertains to autoimmune diseases in particular since these tend to affect women of childbearing age. The interaction between pregnancy and autoimmune disease may increase the risk of maternal, fetal, and obstetric complications; additional care may be required.
METHODS
This review is based on a selective literature search in PubMed (2015-2020).
RESULTS
In women with autoimmune diseases, the course of pregnancy is highly variable. Some autoimmune diseases tend to improve during pregnancy and do not to result in any serious obstetric complications. Others may worsen during pregnancy, with deterioration of the maternal condition as well as obstetric and perinatal complications. In systemic lupus erythematosus and myasthenia gravis, placental transfer of specific autoantibodies may cause fetal or neonatal disease.
CONCLUSION
The care of pregnant women with chronic diseases requires collaboration between specialists of the pertinent levels of care. A stable course of disease before conception, close interdisciplinary care, and pregnancy-compatible medication contribute to a reduction in maternal and perinatal complications.
背景
患有慢性病的女性怀孕的情况越来越多。这尤其与自身免疫性疾病有关，因为这些疾病往往会影响到生育年龄的女性。妊娠和自身免疫性疾病之间的相互作用可能会增加母亲、胎儿和产科并发症的风险；可能需要额外的护理。
方法
这篇综述是基于对 PubMed（2015-2020 年）的选择性文献检索。
结果
在患有自身免疫性疾病的女性中，妊娠过程高度可变。一些自身免疫性疾病在妊娠期间趋于改善，不会导致任何严重的产科并发症。其他疾病可能在妊娠期间恶化，导致母体状况恶化以及产科和围产期并发症。在系统性红斑狼疮和重症肌无力中，特定自身抗体的胎盘转移可能导致胎儿或新生儿疾病。
结论
患有慢性病的孕妇的护理需要相关护理水平的专家之间的合作。在受孕前疾病稳定的病程、密切的跨学科护理以及妊娠兼容的药物治疗有助于减少母亲和围产期并发症。
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