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Impact of infections in autoimmune rheumatic diseases and pregnancy

Jara, Luis J.a,d; Cruz-Dominguez, Maria del Pilarb,d; Saavedra, Miguel A.c,d

doi: 10.1097/BOR.0000000000000636
INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld
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Purpose of review To provide an update about the impact of infections in autoimmune rheumatic diseases (ARDs), from the analysis of the role of infections in pregnant women without ARDs, to the identification of maternal–fetal infections and their role in the maternal–fetal outcome of women with ARDs.

Recent findings Recent studies indicate that patients with ARDs and pregnancy are also susceptible to presenting infections of varying degrees, including serious infections, which contribute to the morbidity and mortality observed in pregnancy and postpartum of these patients.

Any type of infectious agent will interact with a hormonal, immunological and metabolic environments modified by ARD, treatments, and by the changes inherent in pregnancy. Therefore, infections in the pregnancy of patients with ARDs should be considered as a risk factor for an unfavorable maternal–fetal outcome.

Summary The recognition of infections in the pregnancy of ARDs as a risk factor is the first step to prevent, identify, and treat them in a timely manner, and thus contribute to the favorable course of pregnancy in these patients. Patients with ARDs and major organ involvement, use of high doses of steroids, immunosuppressant and biological therapies, adolescence, and obesity are populations susceptible to developing infections.

aDirection of Education and Research

bResearch Division

cRheumatology Department, Hospital de Especialidades, Centro Médico Nacional La Raza, IMSS, Seris/Zaachila S/N, Colonia La Raza

dUniversidad Nacional Autónoma de México, Mexico City, Mexico

Correspondence to Luis J. Jara, MD, Hospital de Especialidades ‘Dr Antonio Fraga Mouret’, Centro Médico La Raza, Instituto Mexicano del Seguro Social (IMSS), Seris/Zaachila S/N, Colonia La Raza, Mexico City 02990, Mexico. E-mail: luis_jara_quezada@hotmail.com

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