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Neonatal outcome in patients with rheumatic disease

Neonatology and Neonatal Intensive Care, Spedali Civili, Brescia, Italy, lvmott{at}tin.it

A Tincani

Division of Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy

A Lojacono

Division of Obstetrics and Gynecology, Spedali Civili, Brescia, Italy

D Faden

Division of Obstetrics and Gynecology, Spedali Civili, Brescia, Italy

R Gorla

Division of Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy

P Airò

Division of Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy

F Neri

Pediatric Neuropsychiatry Institute, University of Brescia, Italy

A Gasparoni

Neonatology and Neonatal Intensive Care, Spedali Civili, Brescia, Italy

L Ciardelli

Research Laboratory, Policlinico S. Matteo IRCCS, Pavia, Italy

A de Silvestri

Research Laboratory, Policlinico S. Matteo IRCCS, Pavia, Italy

M Marconi

Research Laboratory, Policlinico S. Matteo IRCCS, Pavia, Italy

G Chirico

Neonatology and Neonatal Intensive Care, Spedali Civili, Brescia, Italy

Rheumatic autoimmune diseases have a higher prevalence in women, particularly during their childbearing age. Due to improved management, an increasing number of patients plan and carry out one or more pregnancies. Therefore, a growing interest is being paid to the possible consequences of maternal disease and associated treatment on the fetus and newborn infant. If maternal disease is characterized by the presence of IgG isotype autoantibodies, these can cross the placenta with possible antibody-mediated damage to the fetus. This is typically the case of the so called neonatal lupus erythematosus (NLE); a similar mechanism has been shown in infants of patients with immune thrombocytopenic purpura (ITP) and, less frequently, in those from mothers with antiphospholipid syndrome (APS). Indeed, this last condition is often responsible for placental, rather than neonatal, pathology. In addition, immunosuppressive and other drugs administered to the mothers during pregnancy and lactation might affect the fetal and neonatal immune system development. Finally, mothers disease and/or treatment could be related to neuropsychological alteration reported in some of their children.

Key Words: antiphospholipid syndrome • breastfeeding • immune system • neonatal lupus erythematosus • neonatal thrombocytopenia • pregnancy

Lupus, Vol. 13, No. 9, 718-723 (2004)
DOI: 10.1191/0961203403lu2002oa


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