Abstract Details

Title Pregnancy and Neurologic Involvement in Women with Autoimmune Rheumatologic Diseases: Review of Literature and Future Directions

Topic Autoimmune Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-009

Objective To review maternal and fetal risks, and neurologic complications in peri-partum patients with Systemic lupus erythematosus (SLE), Sjögren’s syndrome (SS) , Sarcoidosis and Behçet’s disease (BD).

Background SLE, SS, sarcoidosis, and BD affect women of reproductive age and may complicate pregnancy. Peri-partum neurologic involvement may be clinically significant, but has poorly defined pregnancy outcomes.

Design/Methods A PubMed review (2010–2025) included observational, cohort, case–control, and case series studies, excluding reviews. Data on maternal, and fetal complications, and neurologic involvement was assessed.

Results

Thirty-seven relevant studies were identified. Only one study specifically correlated pre-partum neurologic involvement and pregnancy outcomes.

Maternal outcomes showed significantly increased risks of preeclampsia, rheumatologic disease flares, preterm labor, and thromboembolism (SLE, SS, sarcoidosis), and higher rate of cesarean deliveries (sarcoidosis).

Fetal outcomes: Prematurity and intrauterine growth restriction were common in SLE, SS, and sarcoidosis. SLE had additional risks of neonatal lupus and congenital heart block.

BD outcomes were generally favorable.

Therapeutics: Hydroxychloroquine reduced flares and neonatal complications in SLE and SS. Aspirin and anticoagulation improved outcomes in women with antiphospholipid antibodies (SLE) and BD with comorbid vascular disease.

Neurologic involvement: Eleven studies reported seizures, strokes, venous sinus thrombosis, demyelinating syndromes, and neuropsychiatric complications (SLE, SS, sarcoidosis), without outcome stratification. Recent multicenter study showed that neuropsychiatric SLE was independently linked to significantly worse maternal (seizures, preeclampsia, thrombosis) and fetal (IUGR, preterm birth, pregnancy loss) outcomes, highlighting neurologic involvement as a distinct risk factor.

Conclusions Pregnancy in autoimmune systemic rheumatologic diseases carries a high risk of adverse outcomes. Although neurologic involvement is prevalent and serious, it is seldom recognized independently when assessing risks to reproductive outcomes. The absence of prospective, stratified data limits clinical and therapeutic guidance in this area. Future research should explore whether comorbid neurologic involvement contributes independently to poor pregnancy outcomes in this patient population.

Authors/Disclosures
Tal Friedman Korn, MD PRESENTER	Dr. Friedman Korn has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche.
Giovanna Manzano, MD	Dr. Manzano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gilead Sciences. Dr. Manzano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for InfuCare Rx.
Shamik Bhattacharyya, MD, FAAN (Brigham and Women's Hospital)	Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLambda. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Merck. The institution of Dr. Bhattacharyya has received research support from Alexion Pharmaceuticals. The institution of Dr. Bhattacharyya has received research support from National Institute of Health. The institution of Dr. Bhattacharyya has received research support from UCB. The institution of Dr. Bhattacharyya has received research support from Genentech. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care.
Maria K. Houtchens, MD	Dr. Houtchens has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Houtchens has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche . Dr. Houtchens has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Houtchens has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serono. Dr. Houtchens has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Houtchens has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Cravath. Dr. Houtchens has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Beasley . Dr. Houtchens has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Biogen. The institution of Dr. Houtchens has received research support from Genzyme. The institution of Dr. Houtchens has received research support from Biogen. The institution of Dr. Houtchens has received research support from Genentech. The institution of Dr. Houtchens has received research support from Novartis.

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