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2. Long-term outcomes of COVID-19 vaccination in patients with rare and complex connective tissue diseases: The ERN-ReCONNET VACCINATE study

Author

Tani, Chiara, Cardelli, Chiara, Depascale, Roberto, Gamba, Anna, Iaccarino, Luca, Doria, Andrea, Bandeira, Matilde, Dinis, Sara Paiva, Romão, Vasco C., Gotelli, Emanuele, Paolino, Sabrina, Cutolo, Maurizio, Di Giosaffatte, Niccolò, Ferraris, Alessandro, Grammatico, Paola, Cavagna, Lorenzo, Codullo, Veronica, Montecucco, Carlomaurizio, Longo, Valentina, Beretta, Lorenzo, Cavazzana, Ilaria, Fredi, Micaela, Peretti, Silvia, Guiducci, Serena, Matucci-Cerinic, Marco, Bombardieri, Stefano, Burmester, Gerd R., Fonseca, João E., Frank, Charissa, Galetti, Ilaria, Hachulla, Eric, Müller-Ladner, Ulf, Schneider, Matthias, Smith, Vanessa, Tamirou, Farah, Van Laar, Jacob M., Vieira, Ana, D'Urzo, Rossella, Cannizzo, Sara, Gaglioti, Andrea, Marinello, Diana, Talarico, Rosaria, and Mosca, Marta

Published
2023
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3. Modern Management of Pregnancy in Systemic Lupus Erythematosus: From Prenatal Counseling to Postpartum Support.

Author

Gamba, Anna, Zen, Margherita, Depascale, Roberto, Calligaro, Antonia, Gatto, Mariele, Iaccarino, Luca, and Doria, Andrea

Subjects
*SYSTEMIC lupus erythematosus, *ANTIPHOSPHOLIPID syndrome, *PREGNANT women, *FETAL growth retardation, *PREGNANCY, *PUERPERIUM
Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that predominantly affects women of childbearing age. Pregnancy in SLE patients poses unique challenges due to the potential impact on maternal and fetal outcomes. We provide an overview of the management of SLE during pregnancy, including preconception risk stratification and counseling, treatment, and disease activity monitoring. These assessments are critical to minimize maternal and fetal adverse events in pregnant patients with SLE. Disease flares, preeclampsia, antiphospholipid syndrome complications, and maternal mortality are the major risks for a woman with SLE during gestation. Timely treatment of SLE relapse, differentiation of preeclampsia from lupus nephritis, and tailored management for antiphospholipid syndrome are essential for a successful pregnancy. Fetal outcomes include neonatal lupus (NL), preterm birth, cesarean delivery, fetal growth restriction (FGR), and small-for-gestational-age (SGA) infants. We focused on NL, linked to maternal anti-Ro/SS-A and anti-La/SS-B antibodies, which can lead to various manifestations, particularly cardiac abnormalities, in newborns. While there is a common consensus regarding the preventive effect of hydroxychloroquine, the role of echocardiographic monitoring and fluorinated steroid treatment is still debated. Finally, close postpartum monitoring and counseling for subsequent pregnancies are crucial aspects of care. [ABSTRACT FROM AUTHOR]

Published
2024
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