Rheumatic diseases and reproductive outcomes

Rheumatologic diseases are autoimmune disorders that have a high prevalence amongst reproductive-aged women. The alterations in the immune system during pregnancy can cause changes in rheumatic disease activity, and rheumatic diseases themselves can influence reproductive outcomes. In general, rheumatoid arthritis improves during pregnancy, whereas systemic lupus erythematosus tends to worsen. Systemic sclerosis disease activity is not impacted by pregnancy. An obstetrical antiphospholipid syndrome is manifested by recurrent pregnancy losses, particularly once the embryo becomes a fetus and is dependent on the placenta for growth. Neonatal lupus, caused by anti-Ro (SSA) and anti-La (SSB) antibodies, can be a self-limited neonatal disorder with skin, liver, and hematologic abnormalities or can be more severe as these antibodies can interfere with the developing cardiac system. These antibodies are the etiology of 95% of congenital complete heart block.