Fetal and neonatal involvement in maternal rheumatologic disease
Fetal and neonatal involvement in maternal rheumatologic disease
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DOI：
10.1080/14767058.2017.1334048
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发表时间：
2018-01-01
影响因子：
1.8
通讯作者：
Iijima, Shigeo
中科院分区：
文献类型：
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作者：
Iijima, Shigeo
妊娠合并风湿病可能会对胎儿和/或新生儿产生各种影响。母体系统性红斑狼疮(SLE)可导致早产和/或小于胎龄(SGA)分娩和新生儿狼疮(NL)。一些NL新生儿有先天性心脏传导阻滞(CHB)，发病率和死亡率增加，甚至需要起搏器。系统性红斑狼疮患者可能出现抗磷脂综合征，影响胎儿和/或新生儿的预后。涉及原发性干燥综合征(PSS)的妊娠往往会导致早产和低出生体重儿。此外，慢性乙肝是PSS孕妇分娩的新生儿最具挑战性的并发症。患有类风湿性关节炎(RA)的孕妇分娩早产或SGA新生儿的风险增加。此外，RA药物可能对胎儿和母乳喂养的新生儿产生不利影响。患有皮肌炎/多发性肌炎的孕妇自然流产、围产儿死亡和早产的风险增加。目前，尽管早产儿和SGA的发生率增加，但涉及系统性硬化症的妊娠的总体新生儿存活率是好的。总而言之，母体风湿性疾病需要仔细监测，以确保对胎儿和新生儿结局进行尽可能好的管理。
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjogren's syndrome (pSS) tends to result in preterm delivery and low birthweight infants. Moreover, CHB is the most challenging complication for neonates delivered by women with pSS. Pregnant women with rheumatoid arthritis (RA) are at an increased risk for delivering a preterm or SGA neonate. In addition, RA drugs may have adverse effects on the fetus and breast-fed neonate. With dermatomyositis/polymyositis, pregnancies are at increased risk for spontaneous abortion, perinatal death, and preterm delivery. At present, overall neonatal survival rates are good for pregnancies involving systemic sclerosis, despite an increased frequency of premature and SGA neonates. In conclusion, maternal rheumatological diseases require careful monitoring to ensure the best possible management for fetal and neonatal outcomes.