Maternal Mortality and Morbidity in Autoimmune Diseases

Abstract

Women with autoimmune disorders can present with a myriad of symptoms during pregnancy that sometimes causes catastrophic illness. With greater understanding of the interaction between pregnancy and autoimmune disorders as well as interdisciplinary cooperation among physicians, the maternal and infant prognosis can be greatly improved. Pregnancy should be planned after control of active disease and discussion of risks associated with pregnancy. Systemic lupus erythematosus is the most important disorder and can cause severe complications such as nephropathy, encephalopathy, pulmonary hypertension, multiple organ dysfunction and maternal and infant mortality. Women with autoimmune diseases are also at risk of puerperal sepsis. Other important issues include hypertension, preeclampsia, pulmonary hypertension, cardiac dysfunction and hypercoagulable states. Management should be carried out by a multidisciplinary team comprising of obstetricians, rheumatologists, nephrologists, cardiologists, pulmonary physicians and neonatologists. A one-stop clinic for this special pregnant population should be established for these patients.