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Pregnancy in Myositis

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Managing Myositis

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Abstract

Several systemic autoimmune rheumatic diseases (SARDs) may affect both fetal and maternal outcomes in pregnancy. Little information is available regarding pregnancy outcomes in women with idiopathic inflammatory myopathy (IIM; or myositis) where both adaptive and innate immune mechanisms are likely to be involved in the pathogenesis. The immunological pathways leading to complications are unexplored.

Fetal complications like abortion, intrauterine retardation, stillbirth, and prenatal deaths were frequently reported in patients with polymyositis (PM) and dermatomyositis (DM) and are associated with underlying disease activity in the mother. Neither the nature nor the timing of these complications showed significant differences between PM and DM. Fetal outcomes are generally good in mothers with inactive disease. In contrast, maternal outcomes were generally favorable whether the pregnancy occurred during active or inactive disease. Intravenous immunoglobulin (IVIG) seems to be the best choice for both the mother and the baby, but other immunosuppressive drugs and glucocorticoids can also be administered.

Pregnancy in a patient with myositis has to be considered as a high-risk situation requiring close monitoring. Crucial issues for improving pregnancy outcomes include careful planning, ideal timing, and treatment considerations.

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Authors and Affiliations

  1. Division of Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

    Melinda Nagy-Vincze & Katalin Dankó

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  1. Melinda Nagy-Vincze
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  2. Katalin Dankó
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Editors and Affiliations

  1. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Rohit Aggarwal

  2. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Chester V. Oddis

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Nagy-Vincze, M., Dankó, K. (2020). Pregnancy in Myositis. In: Aggarwal, R., Oddis, C. (eds) Managing Myositis. Springer, Cham. https://doi.org/10.1007/978-3-030-15820-0_27

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  • DOI: https://doi.org/10.1007/978-3-030-15820-0_27

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