The outcomes of children born to mothers with autoimmune rheumatic diseases

IF 15 1区 医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-08-01 DOI:10.1016/S2665-9913(24)00096-1
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Abstract

Maternal autoimmune rheumatic diseases can influence the outcomes of children through several life stages. During pregnancy, maternal inflammation and autoantibodies can hinder fetal development and lead to growth restriction, preterm birth, and low birth weight; prematurity, especially at extreme gestational ages, can in turn impair future child health. Treatment with compatible immunomodulatory drugs and preventive medications aims to keep maternal disease under control and minimise the risk of adverse pregnancy outcomes. However, concerns have been raised about the effects of immunomodulatory drugs on neonatal conditions (ie, the risk of serious infections, inadequate responses to vaccinations, and organ toxicity) and long-term outcomes (metabolic and cardiovascular problems and neurodevelopmental disorders). Among the unmet needs of parents with autoimmune rheumatic diseases, there is the estimation of risk for the children to develop autoimmune disorders and the need for reassurance about parenting capacity while living with a chronic condition. This Series paper provides a comprehensive overview of the literature and guidance on discussing these topics with patients.

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患有自身免疫性风湿病的母亲所生子女的结局。
母体自身免疫性风湿病会在多个生命阶段影响儿童的预后。在妊娠期间,母体炎症和自身抗体会阻碍胎儿发育,导致生长受限、早产和出生体重不足;早产,尤其是胎龄过大的早产,反过来又会损害未来儿童的健康。使用相容的免疫调节药物和预防性药物治疗的目的是控制母体疾病,最大限度地降低不良妊娠结局的风险。然而,免疫调节药物对新生儿状况(即发生严重感染、对疫苗接种反应不足和器官毒性的风险)和长期结果(代谢和心血管问题以及神经发育障碍)的影响也引起了人们的关注。患有自身免疫性风湿病的父母尚未满足的需求包括:估计子女患自身免疫性疾病的风险,以及在患有慢性疾病的情况下对养育能力的信心需求。本系列论文全面概述了与患者讨论这些话题的文献和指南。
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来源期刊
Lancet Rheumatology
Lancet Rheumatology RHEUMATOLOGY-
CiteScore
34.70
自引率
3.10%
发文量
279
期刊介绍: The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.
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