Autoimmune diseases are on the rise and studies show that 75 per cent of those affected by such disorders are women. Such diseases are a result of the body's immune system attacking its own tissues, causing inflammation and other serious conditions. The types of autoimmune diseases are:
1. Those that affect one organ or a tissue such as type1 diabetes or Crohn's disease
2.Systemic diseases that affect the whole system such as rheumatoid arthritis and multiple sclerosis
Some common symptoms of autoimmune diseases are pain in joints, stiffness, excessive tiredness and headaches but having these symptoms doesn't necessarily mean that you're prone to autoimmune diseases. These diseases are difficult to diagnose at an early stage and blood tests are used to confirm their presence. Hence, it is important to have a healthy immune system.
Autoimmune diseases combined with pregnancy could have both short-term effects and long-term consequences. Pregnancy affects different autoimmune disorders in diverse ways. For women who have an autoimmune disease and subsequently become pregnant, pregnancy can alleviate rheumatoid arthritis, while aggravating or having no effect on other types of autoimmune diseases. Hormones also play an important role in autoimmune response. Hormonal changes during pregnancy and even at menopause can trigger autoimmune changes.
Autoimmune disorders could occur due to the transplacental transfer of cells between mother and foetus. The foetal micro-chimerism is acquired by the mother during pregnancy and those foetal cells are maintained in the mother for decades. Similarly, there is also a maternal micro-chimerism acquired by the infant during pregnancy. There is a possibility of the foetus having a genetic predisposition of developing the mother's conditions later on in adult life.
According to some experts, the most common autoimmune diseases that affect women during pregnancy are rheumatic diseases, thyroid diseases and type1 diabetes. Thyroid problems are usually manageable in each trimester, provided they're recognised and monitored properly. In some cases, autoimmune diseases could be an indication of avoiding pregnancy due to potential damage to organs. Also, while multiple gestation periods can put a woman at risk, an autoimmune disease along with that could be considered a bigger threat.
Issues may also come up during postpartum care, often related to breastfeeding and resumption, continuation and change of medications. It is important to note that women who suffer from one autoimmune disease are at a risk of developing other types of autoimmune diseases as well.
It is important for women who are diagnosed with autoimmune diseases to have a pre-conception counselling session with both their treating physician and obstetrician. Optimising antenatal outcome by planning pregnancy in their remission phase with least drug dependency and changing certain teratogenic drugs is needed. Even throughout pregnancy, parallel visits to both doctors' help in better management of such pregnancies.