Background:
Autoimmune diseases, especially in women, have been linked to adverse pregnancy outcomes, influenced by factors such as lifestyle changes, dietary variations, and exposure to specific infections and medications. These conditions can complicate pregnancies due to the transfer of maternal antibodies to the fetus, potentially affecting fetal development, including cardiac health. Effective clinical management of autoimmune pregnancies necessitates a multidisciplinary approach and an understanding of the associated risks.
Review Methodology:
The review analyzed the impact of autoimmune disease prevalence on pregnancy outcomes, employing systematic reviews to assess the strength and accuracy of these associations. Researchers searched databases including Cochrane Medline and Embase, examining systematic reviews on the relationship between autoimmune disorders and pregnancy outcomes. They utilized frameworks such as the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Overviews of Reviews (PRIOR) checklist. Data were synthesized quantitatively, estimating relative risks (RRs) and odds ratios (ORs) through meta-analysis.
Key Findings:
The analysis of 32 records comprising 709 primary studies revealed significant risks associated with autoimmune conditions during pregnancy. Notable findings included:
Increased risk of ectopic pregnancy among patients with inflammatory bowel disease (IBD).
Elevated risk of miscarriage among women with systemic lupus erythematosus (SLE), Sjögren’s syndrome, and thyroid autoimmune conditions.
Higher likelihood of gestational hypertension, pre-eclampsia, and gestational diabetes in various autoimmune disorders.
Increased odds of cesarean section delivery and postpartum depression among specific autoimmune conditions.
Greater risk of intrauterine growth restriction (IUGR), small for gestational age (SGA) babies, and stillbirth in women with certain autoimmune diseases.
Elevated risk of preterm birth, low birth weight, and neonatal mortality associated with autoimmune disorders.
Conclusion:
The review underscores the heightened risk of adverse pregnancy outcomes in women with autoimmune disorders. While these findings provide valuable insights, further research is necessary to establish evidence-based guidelines aiding physicians and patients in making informed decisions regarding the management of autoimmune diseases before and during pregnancy.
