IMPACT OF AUTOIMMUNE RHEUMATOLOGICAL DISEASES IN PREGNANT WOMEN: EVALUATION OF OBSTETRIC COMPLICATIONS AND SURGICAL THERAPIES

Abstract

Introduction: The impact of autoimmune rheumatologic diseases on pregnant women presents a significant challenge for both maternal and fetal health. These conditions, which include systemic lupus erythematosus, rheumatoid arthritis, and Sjögren's syndrome, can exacerbate obstetric complications and influence the effectiveness of therapies employed. The presence of these diseases during pregnancy is associated with an increased risk of preterm birth, preeclampsia, and fetal growth restriction, making it essential to understand their implications for appropriate management. The scientific literature has focused on these complex interactions, but a systematic review is needed to compile and analyze the existing data. Objective: To examine the obstetric complications associated with autoimmune rheumatologic diseases in pregnant women, as well as to evaluate the surgical therapies used and their impact on maternal and fetal health. Methodology: The review was conducted following the PRISMA checklist, using the PubMed, Scielo, and Web of Science databases. The descriptors used were "rheumatological diseases", "pregnancy", "obstetric complications", "surgical therapies" and "autoimmunity". The inclusion criteria consisted of: articles published in the last 10 years, studies involving pregnant women with autoimmune rheumatological diseases and publications in English, Portuguese or Spanish. Articles that addressed only non-autoimmune rheumatological diseases, animal studies and literature reviews that did not present original data were excluded. Results: The results revealed a significant correlation between autoimmune rheumatological diseases and an increased rate of complications such as spontaneous abortions, gestational hypertension and neonatal complications. Additionally, surgical therapies, although necessary in some cases, presented additional risks, demanding a careful assessment of their benefits and disadvantages for the health of the mother and fetus. Conclusion: The analysis showed that autoimmune rheumatological diseases in pregnant women require strict monitoring and adapted management strategies. Understanding the associated complications and available therapies is vital to improving obstetric and neonatal outcomes, highlighting the importance of a multidisciplinary approach in the care of these patients.