Autoimmune diseases of the digestive system during pregnancy

Kamilė Piesliakaitė1, Živilė Sabonytė – Balšaitienė2, 3, Diana Ramašauskaitė2, 3, Virginija Paliulytė2, 3

1Vilnius University, Faculty of Medicine, Vilnius, Lithuania

2Vilnius University, Faculty of Medicine, Clinic of Obstetrics and Gynecology, Vilnius, Lithuania

3Vilnius University Hospital Santaros Clinics, Center of Obstetrics and Gynecology, Vilnius, Lithuania


Background. Autoimmune diseases of the digestive tract are more prevalent in women and have a negative impact on maternal or fetal health. Most common of these diseases are celiac disease, inflammatory bowel disease, autoimmune hepatitis, primary sclerosing cholangitis, and primary biliary cholangitis. Even though they usually tend to go into remission, the underlying pathological pathways may cause complications. Most frequent pregnancy risks include preterm birth, miscarriage, cesarian section, or low birth weight newborn.

Aim: the aim of the study is to analyze and review the evidence-based scientific literature describing the relationship between autoimmune diseases and pregnancy, maternal or fetal complications.

Methods. International databases PubMed and Google Scholar were used for literature review. 53 scientific articles were selected for this literature review.

Results. Celiac disease poses a risk of cesarean section, recurrent miscarriages, low birth weight and preterm delivery, especially for untreated women. Inflammatory bowel disease may cause hemostatic complications in women, preterm birth, small for gestational age birth weight, or stillbirth. Autoimmune hepatitis could lead to fetal loss premature delivery. Primary sclerosing cholangitis and primary biliary cirrhosis increase the risk of cesarean section and preterm birth.

Conclusions. Autoimmune diseases of the digestive tract are not common in pregnancy and most cases will be in remission. Preterm birth, caesarean section or small for gestational age fetus are most common complications. Careful multidiscipline follow-up of obstetrician-gynecologist and gastroenterologist is crucial for reducing pregnancy, maternal, or fetal risks.

Keywords: pregnancy; celiac disease; inflammatory bowel disease; autoimmune hepatitis; primary sclerosing cholangitis; primary biliary cholangitis

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