A recently published study in the journal eClinicalMedicine has unveiled new insights into the complex relationship between autoimmune disease and pregnancy. The research, conducted by the Institute for Systems Biology (ISB) and Providence, challenges the prevailing wisdom that all autoimmune diseases pose a high risk for pregnancy. Instead, the study reveals nuanced outcomes depending on the specific autoimmune condition and individual factors.
For individuals with autoimmune diseases, the prospect of pregnancy can be daunting due to concerns about the impact of their disease and treatment on pregnancy outcomes. Some have opted not to pursue pregnancy at all, fearing potential complications. However, the findings of this study suggest that a one-size-fits-all approach is not appropriate and highlight the need for further investigation in this field.
The research team analyzed electronic health records of over 365,000 pregnant individuals over a 10-year period. Among these individuals, more than 5,700 had at least one of 12 autoimmune disorders, including psoriasis, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, and systemic lupus erythematosus, among others.
The study incorporated a wide range of pregnancy and maternal characteristics, as well as comorbidities such as hypertension and diabetes. The results revealed a complex relationship between autoimmune disease and pregnancy outcomes. The researchers found that a blanket statement claiming that all autoimmune diseases pose a high risk for pregnancy is insufficient. Each autoimmune disease is unique, and the individual’s medical history and risks may change throughout pregnancy.
Dr. Philip Mease, a rheumatology expert from Providence and part of the study team, emphasizes the importance of consulting with an autoimmune disease specialist when considering pregnancy. He advises individuals with autoimmune diseases who are either pregnant or planning to have a baby to discuss the many factors to consider, including treatment options and potential risks.
One unexpected finding from the study was that rheumatoid arthritis and inflammatory bowel disease, after 20 weeks of gestational age, were not necessarily associated with an increased risk of preterm birth. This discovery raises questions about the interplay between autoimmune diseases and comorbidities.
The study also highlights the need for prospective studies that cover the entire duration of pregnancy and delve into the severity and management of both autoimmune diseases and accompanying medical conditions. By gathering more detailed information on these factors, researchers can gain a better understanding of the complexities involved in autoimmune disease and pregnancy.
The results of this study have the potential to reshape discussions and bring a fresh perspective to an area that has been traditionally understudied. By recognizing the nuances and unique circumstances surrounding each autoimmune disease, healthcare professionals can provide tailored guidance and support to individuals with autoimmune diseases who are considering or actively engaged in pregnancy.