Pregnant women with autoimmune diseases (AIDs) have higher probabilities of maternal and fetal complications. AIDs have a variable behavior during pregnancy: while some improve, others remain stable and several worsen with associated poor obstetric and perinatal outcomes. The aim of this study was to describe AIDs and obstetric outcomes in pregnant women.
This is a retrospective study carried out between 2011-2020 in Cali, Colombia. Pregnant women with diagnosis of AIDs were included. Demographic, clinical and laboratory features, as well as obstetric and fetal outcomes including intensive care unit (ICU) characteristics were evaluated.
Fifty-six pregnant women with AIDs were included. Mean age was 29.6 (4.9%) years. Fourty-eight (85.7%) patients had Systemic Lupus Erythematosus (SLE), of which five had polyautoimmunity; six (10.7%) had antiphospholipid syndrome; one (1.8%) rheumatoid arthritis, and one (1.8%) inflammatory myopathies. Diagnosis was made before pregnancy in 41 (73.2%) with an average duration of disease of 56.6 (53.9) months. Of SLE patients, 13/48(27.1%) presented lupus nephritis. Preterm labor (38, 67.9%), preeclampsia (28, 50%), prelabor rupture of membranes (11, 19.6%), were the most common complications. Twenty-two (39.3%) patients required ICU; 40,9% of them due to AID activity, 27.3% for cardiovascular damage, 9.1% for septic shock, and 9,1% for acute kidney failure. Fetal survival was 80.4% (N=45/56). Two were diagnosed with neonatal lupus and two with congenital heart block. One maternal death was registered due to preeclampsia and intraventricular hemorrhage.
This is the first description of AIDs during pregnancy in Colombia.