系统性自身免疫性疾病的围孕期管理和挑战

Perinatal management and challenges of systemic autoimmune diseases

女妊娠合并自身免疫性疾病是一个极具挑战性的领域,涉及免疫学、风湿病学和产科等多学科的管理。妊娠期母体免疫系统在维持对胎儿的免疫耐受和自身免疫平衡之间动态调节然而,对于患有系统性红斑狼疮、抗磷脂综合征、类风湿性关节炎等常见系统性自身免疫性疾病的女性,这一平衡可能被打破,导致疾病加重或复发,并显著增加妊娠并发症的风险。本文阐述了妊娠期免疫系统的适应性变化及系统性自身免疫性疾病对妊娠结局的影响,提出围孕期多学科综合管理策略及其面临的挑战,旨在为优化临床实践提供参考,改善妊娠结局。

Pregnancy with autoimmune diseases is a challenging area that involves multidisciplinary management of immunology,rheumatology,and obstetrics.During pregnancy,the maternal immune system dynamically regulates the balance between maintaining immune tolerance to the fetus and autoimmune.However,for women with common systemic autoimmune diseases such as systemic lupus erythematosus,antiphospholipid syndrome,and rheumatoid arthritis,this balance can be upset,leading to exacerbation or recurrence of the disease and significantly increasing the risk of pregnancy complications.This pape describes the adaptive changes of the immune system during pregnancy and the effects of systemic autoimmune diseases on pregnancy outcomes,proposes multidisciplinary management strategies and challenges in perinatal pregnancy,and aims to provide references for optimizing clinical practice and improving pregnancy outcomes.