Exacerbations of autoimmune diseases during pregnancy and postpartum

Vânia Vieira Borba, Gisele Zandman-Goddard, Yehuda Shoenfeld*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Autoimmune diseases represent a complex heterogeneous group of disorders that occur as a results of immune homeostasis dysregulation and loss of self-tolerance. Interestingly, more than 80% of the cases are found among women at reproductive age. Normal pregnancy is associated with remarkable changes in the immune and endocrine signaling required to tolerate and support the development and survival of the placenta and the semi-allogenic fetus in the hostile maternal immune system environment. Gravidity and postpartum represent an extremely challenge period, and likewise the general population, women suffering from autoimmune disorders attempt pregnancy. Effective preconception counseling and subsequent gestation and postpartum follow-up are crucial for improving mother and child outcomes. This comprehensive review provides information about the different pathways modulating autoimmune diseases activity and severity, such as the influence hormones, microbiome, infections, vaccines, among others, as well as updated recommendations were needed, in order to offer those women better medical care and life quality.

Original languageEnglish
Article number101321
JournalBest Practice and Research: Clinical Endocrinology and Metabolism
Issue number6
StatePublished - Dec 2019


  • autoimmune diseases
  • disease activity
  • postpartum
  • pregnancy
  • prolactin
  • sex hormones


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