title: [Systemic autoimmune disorders and pregnancy].
abstract: The coincidence of systemic autoimmune diseases and pregnancy may modify the outcome of the disease and the pregnancy due to the background immunologic and hormonal processes. The great majority of patients with autoimmune diseases are young females in their reproductive years, willing to have babies. Consequently, we have to prepare for this special situation. Our concept on childbearing in autoimmune women has changed within the last 30 years. Earlier, systemic lupus erythematosus flared in about 50% of patients during pregnancy, but the flare rate has significantly decreased recently. This improvement can be attributed to increased attention to low diseases activity at the time of conception, which might reduce to the half of the risk for flare. Tight control of patients and appropriate use of corticosteroids also contribute to the better results. The adequate use of anti-thrombotic agents resulted in a significant amelioration of pregnancy outcome in antiphospholipid syndrome. The earlier use of methotrexate and the introduction of tumor necrosis factor-alpha inhibitors in the treatment of rheumatoid arthritis have changed the natural characteristics of the disease. The increase in remission rate indirectly has beneficial effect on the number of planned and carried out pregnancies. Authors review the connection between systemic autoimmune disorders and pregnancy as well as the possibilities of medical treatment of such diseases during pregnancy.
authors: Országos Reumatológiai és Fizioterápiás Intézet, Budapest. drkissemese@freemail.hu
authors: Emese
authors: E
authors: Kiss
authors: Csaba György
authors: CG
authors: Kiss
authors: Gyula
authors: G
authors: Poór
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000962:Antimalarials / Q000008:administration & dosage; D016736:Antiphospholipid Syndrome / Q000188:drug therapy / Q000276:immunology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D001379:Azathioprine / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D016572:Cyclosporine / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007555:Isoxazoles / Q000008:administration & dosage; D000077339:Leflunomide; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000276:immunology; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000276:immunology*; D011256:Pregnancy Outcome; D012074:Remission Induction; D012859:Sjogren's Syndrome / Q000188:drug therapy / Q000276:immunology; D012460:Sulfasalazine / Q000008:administration & dosage; D013723:Teratogens; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000962:Antimalarials; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D013723:Teratogens; D014409:Tumor Necrosis Factor-alpha; D012460:Sulfasalazine; D016572:Cyclosporine; D003520:Cyclophosphamide; D000077339:Leflunomide; D001379:Azathioprine; D008727:Methotrexate