• Waltraut Maria Merz, Rebecca Fischer-Betz, Kerstin Hellwig, Georg Lamprecht, and Ulrich Gembruch.
• Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn; Department of Rheumatology and Hiller, Forschungszentrum University Hospital Düsseldorf; Katholisches Klinikum Bochum, Neurology Clinic,Clinic of Ruhr-Universität Bochum; Department of Medicine II, Division of Gastroenterology and Endocrinology, University Medical Center Rostock; Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn.
• Dtsch Arztebl Int. 2022 Mar 4; 119 (9): 145156145-156.

BackgroundPregnancies in women with chronic disease are on the rise. This pertains to autoimmune diseases in particular since these tend to affect women of childbearing age. The interaction between pregnancy and autoimmune disease may increase the risk of maternal, fetal, and obstetric complications; additional care may be required.MethodsThis review is based on a selective literature search in PubMed (2015-2020).ResultsIn women with autoimmune diseases, the course of pregnancy is highly variable. Some autoimmune diseases tend to improve during pregnancy and do not to result in any serious obstetric complications. Others may worsen during pregnancy, with deterioration of the maternal condition as well as obstetric and perinatal complications. In systemic lupus erythematosus and myasthenia gravis, placental transfer of specific autoantibodies may cause fetal or neonatal disease.ConclusionThe care of pregnant women with chronic diseases requires collaboration between specialists of the pertinent levels of care. A stable course of disease before conception, close interdisciplinary care, and pregnancy-compatible medication contribute to a reduction in maternal and perinatal complications.

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