Study: More expectant mothers begin pregnancy with autoimmune conditions

Thousands more UK women who are having children have been diagnosed with an autoimmune condition now compared to the beginning of the millennium.

In a paper published in Lancet Rheumatology today, researchers involved in the MuM-PreDiCT project run by the University of Birmingham and funded by the Medical Research Council have found that there has been increase by 4.7% in expectant mothers beginning pregnancy with autoimmune conditions.

Analysis of electronic healthcare records (CPRD) taken from 2000-2021 found that there was a rise in conditions diagnosed pre-pregnancy in women aged 15-49 including psoriasis, coeliac disease and type 1 diabetes mellitus as well as rarer conditions such as Grave's disease and Hashimoto thyroiditis.

Dr. Megha Singh from the University of Birmingham and lead author of the study said:

"This is the first time that this kind of study has been done, showing that there is a rise in autoimmune conditions in women that are becoming pregnant. We looked at a wide range of autoimmune conditions, unlike any study previously carried out, and we know that these conditions by and large affect women and previous studies have shown that there is an increase overall in autoimmune conditions. As a result, these findings are not surprising, but are crucial for public health.

"Our project is all about understanding how to support women during pregnancy who are managing medical conditions, often co-morbidly, and this data gives us a much better idea about the scale of autoimmune conditions for expectant mums."

Further analysis of the data for factors of deprivation, ethnicity and other factors shows that the least deprived areas saw a 10% rise in pre-pregnancy autoimmune condition diagnosis, and ethnic minority groups of women had lower incidence rates compared to white women. However, some conditions such as psoriasis were more prevalent among deprived areas and among some ethnic minority groups.

There are likely to be a combination of factors driving the increase in autoimmune condition diagnoses before pregnancy, including different factors among groups of people. An awareness of conditions and differential access to healthcare may be involved, and it is very likely therefore that the numbers we are seeing under reports the real scale of women's health in pregnancy."

Dr. Francesca Crowe, senior author, University of Birmingham

Prof Krish Nirantharakumar, corresponding and co-author from King's College London said: "This important study will aid clinicians and policy makers to redefine existing care- pathways and plan future health services for pregnant women with autoimmune conditions to achieve better outcomes for mums and their babies."