Autoimmune Disease and Recurrent Pregnancy Loss

Dr. Braverman discusses the association between autoimmune disease and recurrent pregnancy loss as well as the mechanisms that are most likely responsible.

Many patients at my practice present with a history of recurring pregnancy loss and some have a history of autoimmune diseases associated with this recurring pregnancy loss. Many of these patients surprisingly are not immediately referred to our center as there is still a grey of misconception as to the contribution of autoimmune disease to the process of recurring pregnancy loss. It is important to understand that the same mechanisms that each organ in the body must use to protect itself from the maternal immune system are the same mechanisms that an embryo must use to create immune tolerance for itself.

So it is logical that when there is a break down in the mother's own immune system to the point where it is attacking her own organs, her own blood vessels that it is more than likely that the embryo is going to have a problem protecting itself from the internal immune system. Our patients present here with issues that can be addressed and usually these issues can be treated successfully. Most immune disorders that we see here can usually be broken down into two varieties.

Some are antibody mediated with the most common being systemic lupus and some are driven by inflammatory chemicals called cytokines that drive blood cells to attack different organs the most common of these are Crohn's disease, multiple sclerosis and even rheumatoid arthritis. While the mechanisms of how these different autoimmune diseases attack the embryo are clearly different. In the end they all seem to have similar effects on causing repetitive pregnancy loss. So, at my practice we understand how each of these autoimmune diseases interacts with embryo's mechanism of trying to create immune tolerance for itself and we have tailored specific treatments for each of these syndromes with great success.

If you have been told that your autoimmune disease is not playing a part in your current pregnancy loss because the disease itself is not active or you only have a mild form of the disease this really doesn't matter. Whatever the immune defect is that is causing the body to attack its own organs that defect is always going to be present and it's going to prevent the embryo from developing its immune tolerance. So it's important to get the proper treatments not only early in the pregnancy, to allow normal implantation of the embryo and the placenta, but these treatments many times in patients with autoimmune disease must be carried out throughout the entire pregnancy in order to prevent late pregnancy complications such a placental abruption, intrauterine growth retardation and even in some cases still birth.

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