Pregnancy Induced Autoimmune Diseases

Abstract

Autoimmune diseases have been seen in approximately 8% of the population, and about 80% of these patients are women (Fairweather and Rose 2004). The interaction between autoimmunity and reproduction has two sides. On the one hand, pregnancy may cause de novo autoimmune diseases, especially after pregnancy; and on the other hand, pregnancy may change the course of autoimmune disease regarding its severity and exacerbations (Borchers et al. 2010). After vaginal or cesarean deliveries, and induced abortion, maternal risk of autoimmune disease development is increased and continues to have increased incidence in post-reproductive years (Bianchi et al. 1996). Considering the clinical similarities of chronic graft-versus-host disease and the complex nature of autoimmunity manifested by some autoimmune diseases; persistent fetal microchimerism, the maternal acquisition of intact cells of fetal origin without any apparent rejection may play a role in autoimmune disorders (Shrivastava et al. 2019). Microchimerism is a common phenomenon going on with the presence of genetically distinct cells in the individual and can be seen in 70% of healthy women. Although microchimerism probably occurs in small quantities, microchimeric cells have remarkable effects on women's health (Gammill and Nelson 2010). Fetal microchimerism as a phenomenon was hypothesized to be responsible for the de novo autoimmune diseases’ occurrence; however, published data regarding the pregnancy-related autoimmune diseases are still controversial and debated. This chapter discusses pregnancy-induced autoimmunity and its effects on women's health in the light of studies investigating microchimerism and related conditions.