Pregnancy Outcomes in Autoimmune Diseases

Autoimmune diseases are common in reproductive age group. Pregnancy is known to alter the disease course in many patients with autoimmune diseases.The aim of this study is to assess the impact of autoimmune connective tissue disorders and its treatment on the outcomes of pregnancy. Methods: 15 antenatal patients with autoimmune connective tissue diseases, comprising of Systemic Lupus Erythematosus (SLE), antiphospholipid antibody syndrome (APS), Undifferentiated Connective Tissue Diseases (UCTD), Rheumatoid Arthritis(RA),Sjogren’s syndrome, systemic sclerosis were analyzed with respect to their parity, obstetric history, course during the pregnancy and maternal and fetal outcomes. Results. The primary autoimmune disease was Systemic lupus erythematosus in 5 patients, 3 patients had Rheumatoid arthritis, 2 patients had Systemic sclerosis, 3 patients had Undifferentiated connective tissue disease and 1 patient each had sjogren’s syndrome and Primary Antiphospholipid antibody syndrome. : 6 patients had active underlying disease at the time of pregnancy. 2 patients had bad obstetric history. 2 had preterm induced vaginal deliveries and 1had preterm LSCS. Maternal complications of pre-eclampsia, eclampsia was observed in 2 patients with SLE and APS Fetal growth restriction was observed in 3 patients. Intrauterine death was reported in 2 patients. 1 patient with severe Systemic lupus erythematosus with Anti phospholipid antibody syndrome expired at 26 weeks of gestation. Conclusions: Patients with active underlying disease had more adverse outcomes like maternal mortality, FGR, Preterm delivery and still birth. Well controlled underlying autoimmune disease improves the maternal and fetal outcome