Pregnancy reacts to different autoimmune diseases differently.
For instance, pregnancy can ameliorate a mother’s rheumatoid arthritis while exacerbate or have no effect on other autoimmune diseases like systemic lupus erythematosus.
Some of the most common autoimmune diseases are:
- Graves disease – happens when abnormal antibodies stimulate the thyroid gland to produce excess thyroid hormone; these antibodies may cross the placenta and stimulate the thyroid gland in the foetus, thwarting the foetus’s growth.
- Antiphospholipid syndrome – characterised by excessive blood clotting which can lead to miscarriage or stillbirth.
- Systemic lupus erythematosus – chronic inflammation of connective tissues like joints, kidneys, skin, mucous membranes, and blood vessel walls. During pregnancy, lupus may appear for the first time or the existing ones can flare-up.
- Rheumatoid arthritis – a case of inflammatory arthritis in which joints in the hands and feet get inflamed, resulting in swelling, pain, and destruction of joints.
It may develop during pregnancy or shortly after delivery. Pregnancy is known to lessen and subdue the symptoms of rheumatoid arthritis.
Apart from these, there may be other rarer autoimmune disorders like scleroderma and Sjögren’s syndrome that can plague pregnancy. Also important to note is that women who suffer from one autoimmune disease are also at risk for another.
Diagnosis has to be done on a case-by-case basis by doctors to opine whether a healthy pregnancy can be carried out or not when complicated with autoimmune diseases in the mother.
For instance, women with a lupus with hypertensive flare from a previous pregnancy may be discouraged from going ahead with another pregnancy. Pregnancy in these women may have serious repercussions. They can lose their sight, have a stroke, or even die.
Doctors have to see if the autoimmune disease can potentially cause any kidney disease or massive blood pressure fluctuation in the mother. Occasionally, a woman can have antibodies against her ovary or other reproductive system components that could gravely jeopardise conceiving.
To conclude, how autoimmune diseases affect pregnancy would be determined at the end by which organ systems are involved.
- Kidney disease and heart disease can pose problems throughout pregnancy.
- Thyroid conditions are generally manageable during each trimester if recognized and followed properly.
- In rheumatic or joint conditions, joint problems can worsen. Women with joint damage often hurt more and have more difficulty as pregnancy progress.
- High Blood Pressure generally emerges later in the pregnancy. There’s also the issue of multiple gestations. Multiple gestations can put any woman at risk, but for women with an autoimmune disease, it’s even more hazardous.
- In patients with lupus and rheumatic diseases, dangerous auto-antibodies like the antiphospholipid antibody can end up with the miscarriage of the foetus (usually in the second trimester).
Hence, women with known cases of autoimmune diseases should consult an obstetrician or gynaecologist before conceiving. Doctors will also be able to guide mothers towards medicines that are safe for use during pregnancy and are necessary for keeping the disease in check.