Published in:
Open Access
01-12-2015 | Research article
Maternal and neonatal outcomes in pregnant women with autoimmune diseases in Pavia, Italy
Authors:
Iolanda Mazzucchelli, Lidia Decembrino, Francesca Garofoli, Giulia Ruffinazzi, Véronique Ramoni, Mariaeva Romano, Elena Prisco, Elena Locatelli, Chiara Cavagnoli, Margherita Simonetta, Annalisa De Silvestri, Piermichele Paolillo, Arsenio Spinillo, Mauro Stronati
Published in:
BMC Pediatrics
|
Issue 1/2015
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Abstract
Background
The increased number of childbearing women with autoimmune diseases leads to a growing interest in studying relationship among maternal disease, therapy, pregnancy and off-spring. The aim of this study was to determine the impact of autoimmune disease on pregnancy and on neonatal outcome, taking into account the maternal treatment and the transplacental autoantibodies passage.
Methods
We studied 70 infants born to 70 pregnant women with autoimmune disease attended in Fondazione IRCCS Policlinico San Matteo, Pavia, Italy from June 2005 to June 2012. Maternal and neonatal characteristics were collected and relevant clinical, laboratory, therapeutics, sonographic and electrocardiographic investigations were recorded and analyzed.
Results
We observed a high rate of spontaneous abortions in medical history, 29 %, and 18.6 % of preterm births and 22.9 % of low birth weight (< 2500 g). Transplacental autoantibodies passage wasn’t related to maternal or obstetrical complication, but anti-Ro/SSA positive pregnancies correlated with abnormal fetal heart rate (P = 0.01). Pregnant women on therapy showed an higher incidence of maternal (p = 0.002), obstetric (p = 0.007) complications and an increased rate of intrauterine growth restriction (p = 0.01) than the untreated ones.
Conclusions
Autoimmune diseases in pregnancy require to be carefully monitored to ensure the best possible management of mothers, fetuses and newborns due to the high rate of morbidity specially in case of maternal polytherapy and/or anti-Ro/SSA positivity.