Do Autoimmune Diseases Affect Pregnancy?

Rheumatic diseases in pregnancy may improve, worsen from current state or remain unchanged. Studies indicate that rheumatoid arthritis improves during pregnancy and flares up following delivery. However, patients with ankylosing spondylitis are not markedly affected by pregnancy. In case of Systemic Lupus Erythematosus (SLE), pregnancy could result in the disease remaining active or in a flare up of the disease. The fetus may also suffer from complications of lupus including congenital heart disease due to spread of antibodies from the mother to the fetus. Primary anti-phospholipid antibody syndrome (APS) could result in recurrent pregnancy losses. The prognosis however has improved with the use of low dose aspirin and anticoagulation. SLE and APS also increase the risk of pre-eclampsia in the mother. Systemic sclerosis (SSc) could result in premature delivery of the fetus, though patients with stable and mild disease could have an uneventful pregnancy. Patients with vasulitis like Behcet's syndrome, Takayasu arteritis and Churg-Strauss syndrome usually have a successful pregnancy and delivery if the disease is well controlled. Besides pregnancy, fertility in males as well as females is affected by rheumatic diseases.

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