title: Maternal and neonatal outcomes in pregnant women with autoimmune diseases in Pavia, Italy.
abstract: BACKGROUND
  The increased number of childbearing women with autoimmune diseases leads to a growing interest in studying relationship among maternal disease, therapy, pregnancy and off-spring. The aim of this study was to determine the impact of autoimmune disease on pregnancy and on neonatal outcome, taking into account the maternal treatment and the transplacental autoantibodies passage.
  
  
  METHODS
  We studied 70 infants born to 70 pregnant women with autoimmune disease attended in Fondazione IRCCS Policlinico San Matteo, Pavia, Italy from June 2005 to June 2012. Maternal and neonatal characteristics were collected and relevant clinical, laboratory, therapeutics, sonographic and electrocardiographic investigations were recorded and analyzed.
  
  
  RESULTS
  We observed a high rate of spontaneous abortions in medical history, 29 %, and 18.6 % of preterm births and 22.9 % of low birth weight (< 2500 g). Transplacental autoantibodies passage wasn't related to maternal or obstetrical complication, but anti-Ro/SSA positive pregnancies correlated with abnormal fetal heart rate (P = 0.01). Pregnant women on therapy showed an higher incidence of maternal (p = 0.002), obstetric (p = 0.007) complications and an increased rate of intrauterine growth restriction (p = 0.01) than the untreated ones.
  
  
  CONCLUSIONS
  Autoimmune diseases in pregnancy require to be carefully monitored to ensure the best possible management of mothers, fetuses and newborns due to the high rate of morbidity specially in case of maternal polytherapy and/or anti-Ro/SSA positivity.
authors.affiliation: Neonatal Unit and Neonatal Intensive Care Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy. iolanda.mazzucchelli@unipv.it.|Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. iolanda.mazzucchelli@unipv.it.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Mazzucchelli
authors.affiliation: Neonatal Unit and Neonatal Intensive Care Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy. lidiadec@alice.it.
authors.forename: Lidia
authors.initials: L
authors.lastname: Decembrino
authors.affiliation: Neonatal Unit and Neonatal Intensive Care Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy. lab.immunoneo@smatteo.pv.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Garofoli
authors.affiliation: Neonatal Unit and Neonatal Intensive Care Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy. giuliaruffinazzi@libero.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ruffinazzi
authors.affiliation: Division of Rheumatology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. v.ramoni@yahoo.it.
authors.forename: Véronique
authors.initials: V
authors.lastname: Ramoni
authors.affiliation: Division of Rheumatology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. mariaeva.romano@hotmail.it.
authors.forename: Mariaeva
authors.initials: M
authors.lastname: Romano
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. prisco.elena@libero.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Prisco
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. elena.loc@libero.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Locatelli
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. chiara1.c@libero.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cavagnoli
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. marghesim@libero.it.
authors.forename: Margherita
authors.initials: M
authors.lastname: Simonetta
authors.affiliation: Biometry Unit, San Matteo Hospital Foundation, P.le Golgi 19, Pavia, 27100, Italy. A.DeSilvestri@smatteo.pv.it.
authors.forename: Annalisa
authors.initials: A
authors.lastname: De Silvestri
authors.affiliation: Division of Neonatology and Neonatal Intensive Care, Casilino General Hospital, Roma, Italy. piermpa@tin.it.
authors.forename: Piermichele
authors.initials: P
authors.lastname: Paolillo
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy. spinillo@smatteo.pv.it.
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
authors.affiliation: Neonatal Unit and Neonatal Intensive Care Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy. m.stronati@smatteo.pv.it.
authors.forename: Mauro
authors.initials: M
authors.lastname: Stronati
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000276:immunology* / Q000628:therapy; D005260:Female; D005317:Fetal Growth Retardation; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007558:Italy; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology* / Q000628:therapy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies