Offspring of Women with Systemic Autoimmune Diseases: Fetal and Neonatal Complications and Inheritance of Autoimmune Diseases

This chapter discusses the women affected by systemic autoimmune diseases. Patients affected by systemic lupus erythematosus (SLE) are discouraged from becoming pregnant. It is observed that the disease can worsen during gestation; high disease activity has profound implications on fetal outcome. Owing to the increasing knowledge of pathophysiologic mechanisms and the development of clinics with combined obstetric and medical care, pregnancy is now a nearly normal event in women with SLE and other autoimmune diseases. Pregnancies in this group of patients remain at high risk, even though now many women do not experience major complications. Potential adverse events include renal crisis in systemic sclerosis (SSc), thrombosis, miscarriage, and preeclampsia in patients with anti-phospholipid antibodies (aPL) with or without SLE, neonatal lupus in babies born to mothers with anti-Ro/SSA antibodies, independent of maternal disease. Some drugs that are used to care for the mothers can interfere with fetal outcome.