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Reynolds JA, Gayed M, Khamashta MA, Leone F, Toescu V, Bruce IN, Giles I, Teh LS, McHugh N, Akil M, Edwards CJ, Gordon C. Outcomes of children born to mothers with systemic lupus erythematosus exposed to hydroxychloroquine or azathioprine. Rheumatology (Oxford) 2022; 62:1124-1135. [PMID: 35766806 PMCID: PMC9977116 DOI: 10.1093/rheumatology/keac372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES HCQ and AZA are used to control disease activity and reduce risk of flare during pregnancy in patients with SLE. The aim of this study was to determine the outcomes of children born to mothers with SLE exposed to HCQ or AZA during pregnancy and breast-feeding. METHODS Women attending UK specialist lupus clinics with children ≤17 years old, born after SLE diagnosis, were recruited to this retrospective study. Data were collected using questionnaires and from clinical record review. Factors associated with the outcomes of low birth weight and childhood infection were determined using multivariable mixed-effects logistic regression models. RESULTS We analysed 284 live births of 199 mothers from 10 UK centres. The first pregnancies of 73.9% of mothers (147/199) were captured in the study; (60.4%) (150/248) and 31.1% (87/280) children were exposed to HCQ and AZA, respectively. There were no significant differences in the frequency of congenital malformations or intrauterine growth restriction between children exposed or not to HCQ or AZA. AZA use was increased in women with a history of hypertension or renal disease. Although AZA was associated with low birth weight in univariate models, there was no significant association in multivariable models. In adjusted models, exposure to AZA was associated with increased reports of childhood infection requiring hospital management [odds ratio 2.283 (1.003, 5.198), P = 0.049]. CONCLUSIONS There were no significant negative outcomes in children exposed to HCQ in pregnancy. AZA use was associated with increased reporting of childhood infection, which warrants further study.
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Affiliation(s)
- John A Reynolds
- Correspondence to: John A. Reynolds, Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham Research Laboratories, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. E-mail:
| | - Mary Gayed
- Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham
| | - Munther A Khamashta
- Lupus Research Unit, St Thomas Hospital,Department of Women and Children’s Health, King’s College London, London
| | - Francesca Leone
- Lupus Research Unit, St Thomas Hospital,Department of Women and Children’s Health, King’s College London, London
| | | | - Ian N Bruce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal & Dermatological Sciences, The University of Manchester,NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester
| | - Ian Giles
- Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London,Department of Rheumatology, University College London Hospital, London
| | - Lee-Suan Teh
- Rheumatology Department, Royal Blackburn Teaching Hospital, Blackburn,University of Central Lancashire, Preston
| | - Neil McHugh
- Department of Pharmacy and Pharmacology, University of Bath, Bath
| | - Mohammed Akil
- Rheumatology Department, Sheffield Teaching Hospitals NHS Trust, Sheffield
| | - Christopher J Edwards
- NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Trust, Southampton
| | - Caroline Gordon
- Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham,Rheumatology Department, Sandwell and West Birmingham NHS Trust,NIHR/Wellcome Trust Clinical Research Facility, Queen Elizabeth Hospital Birmingham, Birmingham, UK
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Ellul P, Acquaviva E, Peyre H, Rosenzwajg M, Gressens P, Klatzmann D, Delorme R. Parental autoimmune and autoinflammatory disorders as multiple risk factors for common neurodevelopmental disorders in offspring: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:112. [PMID: 35304436 PMCID: PMC8933391 DOI: 10.1038/s41398-022-01843-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/10/2023] Open
Abstract
Epidemiological studies have raised concerns about the risk of neurodevelopmental disorders (NDD) in children of patients with autoimmune or inflammatory disorders (AID). The pathophysiological pathways underlying this association are still unknown and little is known about the specific and distinct risk of each AID. To explore these questions, we investigated the association between the occurrences of several NDD in the offspring of mothers or fathers with different IDA. We conducted a meta-analysis-PROSPERO (CRD42020159250)-examining the risk of NDD in the offspring of mothers or fathers with AID. We performed specific analyses separately in fathers or mothers of NDD patients as well as subgroup analyses for each NDD and AID. We searched MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection published until December 2021. From an initial pool of 2074 potentially relevant references, 14 studies were included, involving more than 1,400,000 AID and 10,000,000 control parents, 180,000 children with NDD and more than 14,000,000 control children. We found AID in mothers (Adjusted OR 1.27 [95% CI 1.03; 1.57] p = 0.02, [I2 = 65%, Tau2 = 0.03 p = 0.01] and adjusted OR 1.31 [95% CI 1.11; 1.55] p = 0.001, [I2 = 93%, Tau2 = 0.13 p = 0.001] and, although in a lesser extent, in fathers (adjusted OR 1.18 [95% CI 1.07; 1.30] p = 0.01, [I2 = 15.5%, Tau2 = 0.002 p = 0.47]) and adjusted OR 1.14 [95% CI 1.10; 1.17] p < 0.0001, [I2 = 0%, Tau2 = 0 p = 0.29]) to be associated with ASD and ADHD in the offspring. This difference in the strength of the association was found in the AID-specific analyses, suggesting that AID increase the risk of NDD by a shared mechanism but that a specific maternal route appears to represent an additional excess risk. Inflammatory bowel disease were not associated with an additional risk (neither in fathers nor in mothers) of NDD in offspring. Our results suggest that complex and multiple AID-specific pathophysiological mechanisms may underlie the association of AID and NDD in offspring. Further, comprehensive studies of the different AID and NDD are needed to draw definitive conclusions about the pathophysiological links between parental AID and NDD in children.
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Affiliation(s)
- Pierre Ellul
- Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, Paris, France. .,Immunology-Immunopathology-Immunotherapy (i3), UMRS 959, INSERM, Paris, France.
| | - Eric Acquaviva
- grid.413235.20000 0004 1937 0589Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, Paris, France
| | - Hugo Peyre
- grid.413235.20000 0004 1937 0589Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, Paris, France ,NeuroDiderot, Paris University, INSERM, Paris, France
| | - Michelle Rosenzwajg
- grid.411439.a0000 0001 2150 9058University hospital department Inflammation-Immunopathology-Biotherapy (i2B), Pitié-Salpêtrière Hospital, APHP, Paris, France
| | | | - David Klatzmann
- grid.7429.80000000121866389Immunology-Immunopathology-Immunotherapy (i3), UMRS 959, INSERM, Paris, France ,grid.411439.a0000 0001 2150 9058University hospital department Inflammation-Immunopathology-Biotherapy (i2B), Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Richard Delorme
- grid.413235.20000 0004 1937 0589Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, Paris, France ,grid.428999.70000 0001 2353 6535Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
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3
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Boulay H, Mazaud-Guittot S, Supervielle J, Chemouny JM, Dardier V, Lacroix A, Dion L, Vigneau C. Maternal, foetal and child consequences of immunosuppressive drugs during pregnancy in women with organ transplant: a review. Clin Kidney J 2021; 14:1871-1878. [PMID: 34345409 PMCID: PMC8323135 DOI: 10.1093/ckj/sfab049] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/01/2021] [Indexed: 02/06/2023] Open
Abstract
Although pregnancy remains exceptional in women after heart, liver or lung transplant, obstetricians and nephrologists are regularly confronted with pregnancy in renal transplant recipients. National and international registries have described the epidemiology of maternal, foetal and neonatal complications, and transplantation societies have published recommendations on the monitoring of these high-risk pregnancies. In this review, we summarize the existing data on maternal and foetal complications of pregnancies in women after renal transplant, especially the management of immunosuppression. We also describe the few available data on the middle- and long-term outcomes of their children who were exposed in utero to immunosuppressive drugs.
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Affiliation(s)
- Hugoline Boulay
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Séverine Mazaud-Guittot
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Jeanne Supervielle
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Jonathan M Chemouny
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Virginie Dardier
- Laboratoire de psychologie, comportement, cognition et communication (LP3 C), Université Rennes-Rennes 2, Rennes, France
| | - Agnes Lacroix
- Laboratoire de psychologie, comportement, cognition et communication (LP3 C), Université Rennes-Rennes 2, Rennes, France
| | - Ludivine Dion
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Cécile Vigneau
- University of Rennes, CHU Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
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Green LJ, O’Neill L, Frise CJ. Antisynthetase syndrome in pregnancy: A case and review of the literature. Obstet Med 2020; 13:96-100. [PMID: 32714443 PMCID: PMC7359659 DOI: 10.1177/1753495x18808646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 09/28/2018] [Indexed: 12/13/2022] Open
Abstract
Antisynthetase syndrome is a rare autoimmune, multisystem, inflammatory condition, characterised by autoantibodies against aminoacyl tRNA synthetases. The predominant features are myositis and interstitial lung disease but other symptoms such as Raynaud's phenomenon may also be present. Described here is a 36-year-old woman with antisynthetase syndrome who planned and underwent a successful pregnancy, during which a multidisciplinary team approach secured a good outcome for both mother and baby.
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Affiliation(s)
- Lauren J Green
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Lorraine O’Neill
- Department of Rheumatology, Oxford University Hospitals NHS Foundation Trust, Nuffield Orthopaedic Centre, Oxford, UK
| | - Charlotte J Frise
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
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5
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Eosinophilic gastroenteritis in pregnancy: A review of the literature. Eur J Obstet Gynecol Reprod Biol 2020; 248:102-105. [PMID: 32199294 DOI: 10.1016/j.ejogrb.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/26/2020] [Accepted: 03/05/2020] [Indexed: 11/23/2022]
Abstract
Eosinophilic gastroenteritis (EGE) is an uncommon and heterogeneous disease characterized by eosinophilic infiltration of the gastrointestinal tract. There are very few reports in literature describing pregnancies in EGE patients, and no review has ever been published. We found a total of 12 cases including one that occurred in our clinic. In 5 out of 12 cases, EGE was diagnosed after delivery and pregnancies are described as uneventful. Of the 5 patients who already had a diagnosis of EGE before pregnancy, only one registered an improvement of symptoms during gestation, while the rest had no significant changes, and their pregnancies needed to be monitored as high risk. Regarding pregnancy complications, only two patients had a pre-term delivery. Both patients had not only EGE, but a remarkable obstetrical history, that could slightly complicate the interpretation of the events that occurred in their pregnancies. More studies are necessary to demonstrate if EGE is connected with pre-term onset of labor. It's not easy to define the reasons of some patient's pre term labor, and we could suppose that a combination of different mechanisms leads to this condition of breakdown of maternal-fetal tolerance. Nevertheless, we know that spontaneous preterm labor is a syndrome attributable to multiple pathologic processes and most of them are yet to be understood. However, we cannot exclude that EGE is related to late preterm delivery. We hope that this review will provide some measures of guidance to those clinicians who must satisfy the questions of young female patients diagnosed with EGE and wishing for a pregnancy.
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Drozdowska-Szymczak A, Pietrzak B, Czaplińska N, Schreiber-Zamora J, Jabiry-Zieniewicz Z, Wielgoś M, Kociszewska-Najman B. Immunological Status of Children Born to Female Liver Recipients. Ann Transplant 2018. [PMID: 29545512 PMCID: PMC6248293 DOI: 10.12659/aot.907930] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Immunosuppressive treatment in pregnant organ recipients can affect functions of the fetal and newborn immune system. The aim of this study was to evaluate the effect of this treatment on selected parameters of the immune system of children born to mothers after liver transplantation. Material/Methods The study included 52 children born to liver recipients and 52 children in the control group. The study was conducted in the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw. Children from the 1st day of life to 10 years of age were examined. Serum antibody concentrations of IgG, IgM, and IgA were measured by the immune agglutination method on a Cobas 6000 analyzer. Results Comparison of mean IgG, IgM, and IgA levels and with reference values did not show a significant difference between the study and control group (p>0.05). Immunoglobulin concentrations were also analyzed in the groups of children according to their age at the time of the test and the type of calcineurin inhibitor used in the mother’s treatment. The analysis showed a significant difference in the distribution of IgA concentrations in comparison to the normal values (p<0.05), as well as mean IgA (p<0.05) and IgM concentrations (p<0.05) according to the type of immunosuppressive treatment of the mother (tacrolimus or cyclosporin treatment regimen). Conclusions Analysis of the type of immunosuppressive therapy used during pregnancy revealed a possible influence of the type of calcineurin inhibitor on selected parameters of the immune system of the children; however, further research is needed to confirm these findings.
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Affiliation(s)
- Agnieszka Drozdowska-Szymczak
- Division of Neonatology and Neonatal Intensive Care Unit of First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Bronisława Pietrzak
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Czaplińska
- Division of Neonatology and Neonatal Intensive Care Unit of First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Schreiber-Zamora
- Division of Neonatology and Neonatal Intensive Care Unit of First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Mirosław Wielgoś
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Bożena Kociszewska-Najman
- Division of Neonatology and Neonatal Intensive Care Unit of First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Neves AR, Monteiro P, Matos A, Santos Silva I. Anti-MuSK-positive myasthenia gravis diagnosed during pregnancy: new challenges for an old disease? BMJ Case Rep 2015; 2015:bcr-2014-207708. [PMID: 25564591 DOI: 10.1136/bcr-2014-207708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Myasthenia gravis is an autoimmune disorder affecting predominantly women in their reproductive age. The course of the disease during pregnancy is unpredictable, although it is more difficult to manage earlier in the gestation. Myasthenia gravis with antibodies against the muscle-specific receptor tyrosine kinase (anti-MuSK) has been described as a subtype of disease with more localised clinical features and a poorer response to treatment than acetylcholine receptor antibody (anti-AChR)-positive patients. Few cases have been reported in pregnant women, with deliveries being performed mainly by caesarean section. We report a successful case of vaginal delivery and describe our experience providing the first review of the management of this subtype of disease during pregnancy.
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Affiliation(s)
- Ana Raquel Neves
- Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Pitorra Monteiro
- Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Anabela Matos
- Department of Neurology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Santos Silva
- Department of Obstetrics B, Maternidade Bissaya Barreto-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Nalli C, Iodice A, Andreoli L, Lojacono A, Motta M, Fazzi E, Tincani A. Children born to SLE and APS mothers. Lupus 2014; 23:1246-8. [DOI: 10.1177/0961203314538109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are autoimmune diseases that affect women of childbearing age. Pregnancies in these patients carry several complications such as prematurity. Maternal IgG antiphospholipid antibodies (aPL) can cross the placenta but they don’t generally cause any neonatal thrombotic event. Because of the incompleteness of the fetal blood-brain barrier, aPL could theoretically reach the fetal brain. Whether this can have an effect on brain development is still under investigation. Some studies performed in children of patients with SLE and/or APS showed an increased number of learning disabilities without impairment in intelligence level. Objectives The objectives of this article are to evaluate the neurodevelopment outcome in 30 children (median age 9 years) born to mothers with SLE and/or APS with IgG anti-beta2-glycoprotein I during the third trimester of pregnancy and found positive for the same antibodies at birth. Methods A neurological physical exam was performed in all children. We submitted some questionnaires to the mothers: the Child Behavior CheckList (CBCL) and a homemade set of questions obtained by a team composed of rheumatologists and pediatric neurologists. Intellectual functioning was determined by the Wechsler scale for corrected age. Results In all children neurological physical exam and intelligence levels were found to be normal but mild behavior disorders and history of neurological manifestations were shown in three children. Conclusions Offspring of patients with SLE and/or APS are generally healthy. We and others observed the occurrence of minor neurological disorders that might be related to maternal disease or to prematurity. The limited number of the available data on this sensitive issue supports the need for further studies.
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Affiliation(s)
- C Nalli
- Rheumatology and Clinical Immunology
| | - A Iodice
- Unit of Child and Adolescent Neuropsychiatry
| | | | - A Lojacono
- Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Italy
| | - M Motta
- Neonatology and NICU, Spedali Civili, Brescia, Italy
| | - E Fazzi
- Unit of Child and Adolescent Neuropsychiatry
| | - A Tincani
- Rheumatology and Clinical Immunology
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Abstract
Pregnancy poses an important challenge for doctors looking after women with systemic lupus erythematosus. Knowledge about safety of medications, the effect of pregnancy on such disease, and vice versa, together with multidisciplinary team care, are basic cornerstones needed to provide the best obstetric and medical care to these women. Pre-conceptional counselling constitutes the ideal scenario where a patient's previous obstetric history, organ damage, disease activity, serological profile and additional medical history can be summarized. Important issues regarding medication adjustment, planned scans and visits, and main risks discussion should also be raised at this stage. Planned pregnancies lead to better outcomes for both mothers and babies. Close surveillance throughout pregnancy and the puerperium, and tailored management approach guarantee the highest rates of successful pregnancies in these women.
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Affiliation(s)
- O Ateka-Barrutia
- Lupus Research Unit, Women's Health Division, King's College London, UK
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10
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Soh MC, Nelson-Piercy C. Update of the management of rheumatoid arthritis in pregnancy. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.11.77] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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McPherson T, Venning VV. Management of Autoimmune Blistering Diseases in Pregnancy. Dermatol Clin 2011; 29:585-90. [DOI: 10.1016/j.det.2011.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ostensen M, Brucato A, Carp H, Chambers C, Dolhain RJEM, Doria A, Forger F, Gordon C, Hahn S, Khamashta M, Lockshin MD, Matucci-Cerinic M, Meroni P, Nelson JL, Parke A, Petri M, Raio L, Ruiz-Irastorza G, Silva CA, Tincani A, Villiger PM, Wunder D, Cutolo M. Pregnancy and reproduction in autoimmune rheumatic diseases. Rheumatology (Oxford) 2010; 50:657-64. [DOI: 10.1093/rheumatology/keq350] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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13
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Motta M, Rodriguez-Perez C, Tincani A, Lojacono A, Nacinovich R, Chirico G. Neonates born from mothers with autoimmune disorders. Early Hum Dev 2009; 85:S67-70. [PMID: 19765919 DOI: 10.1016/j.earlhumdev.2009.08.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 07/29/2009] [Accepted: 07/29/2009] [Indexed: 11/26/2022]
Abstract
Systemic autoimmune disorders have a higher prevalence in women, particularly during their childbearing age. A growing interest is being paid to the possible consequences of maternal disease and associated treatment on the fetus and newborn infant. If maternal disease is characterized by the presence of IgG isotype auto-antibodies, these can cross the placenta with possible antibody-mediated damage to the fetus. The risk of gestational complications, including preterm delivery, intrauterine growth retardation and low birth weight is higher in autoimmune diseases rather than in the general population and probably this finding is related to both maternal disorder and immunosuppressive therapy. Recently, results of our studies suggest that the antenatal exposure to immunosuppressive drugs given to mothers during pregnancy to treat autoimmune diseases does not impair significantly the development of immunity in exposed children. Finally, mothers disease and/or treatment could be related to neuropsychological dysfunctions reported in some of their children.
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Affiliation(s)
- Mario Motta
- Neonatal Intensive Care Unit, Children's Hospital of Brescia, Brescia, Italy.
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14
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Østensen M. Management of early aggressive rheumatoid arthritis during pregnancy and lactation. Expert Opin Pharmacother 2009; 10:1469-79. [DOI: 10.1517/14656560902980194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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