How Autoimmune Disorders Can Lead to Miscarriage? - Dr Manisha Rajpal Singh
Miscarriage, the loss of a pregnancy before 20 weeks, is a common phenomenon that affects many women worldwide. While the exact causes of miscarriage can be complex and multifaceted, research has shown that autoimmune factors play a significant role in many cases.
Autoimmune disorders occur when the body's immune system mistakenly attacks healthy cells and tissues, leading to inflammation and damage. In the context of pregnancy, autoimmune factors can disrupt the delicate balance of the immune system, leading to miscarriage.
Antiphospholipid Syndrome (APS): Leading Autoimmune Cause of Miscarriage
One of the most well-established autoimmune causes of miscarriage is Antiphospholipid Syndrome (APS). APS is a disorder in which the immune system produces antibodies that attack phospholipids, a type of fat found in cell membranes.
These antibodies can cause blood clots to form in the placenta, leading to miscarriage. Studies have shown that women with APS are at increased risk of recurrent miscarriage, and that treatment with anticoagulant medications can significantly reduce this risk.
APS is often diagnosed in women who have experienced multiple miscarriages, and testing for APS antibodies is now a routine part of the evaluation for recurrent pregnancy loss.
Thyroid Autoimmunity and Miscarriage
Thyroid autoimmunity is another autoimmune factor that has been linked to miscarriage. Thyroid autoimmunity occurs when the immune system produces antibodies that attack the thyroid gland, leading to inflammation and damage.
Research has shown that women with thyroid autoimmunity are at increased risk of miscarriage, even if they do not have overt thyroid disease. This is because thyroid autoimmunity can disrupt the delicate balance of hormones necessary for pregnancy, leading to implantation failure or early pregnancy loss.
Women with thyroid autoimmunity may benefit from treatment with thyroid hormone replacement therapy, which can help to reduce the risk of miscarriage.
Other Autoimmune Disorders and Miscarriage
In addition to APS and thyroid autoimmunity, other autoimmune disorders have been linked to miscarriage. These include systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and Sjögren's syndrome.
Women with these disorders are at increased risk of miscarriage due to the chronic inflammation and immune dysregulation that characterize these conditions. In some cases, treatment with immunosuppressive medications may be necessary to reduce the risk of miscarriage.
However, the optimal treatment approach for women with autoimmune disorders and miscarriage is still a topic of ongoing research and debate.
Role of Immune Cells in Miscarriage
Recent research has highlighted the important role of immune cells in miscarriage. Immune cells, such as natural killer (NK) cells and T cells, play a crucial role in maintaining the balance of the immune system during pregnancy.
However, in women with autoimmune disorders, these immune cells can become dysregulated, leading to inflammation and damage to the placenta.
Studies have shown that women with recurrent miscarriage have altered immune cell profiles, including increased numbers of NK cells and T cells. Further research is needed to understand the mechanisms by which immune cells contribute to miscarriage and to develop effective treatments.
In conclusion, autoimmune factors play a significant role in many cases of miscarriage. APS, thyroid autoimmunity, and other autoimmune disorders can disrupt the delicate balance of the immune system, leading to inflammation and damage to the placenta.
Further research is needed to understand the mechanisms by which autoimmune factors contribute to miscarriage and to develop effective treatments. Women who have experienced recurrent miscarriage should be evaluated for autoimmune disorders, and treatment with immunosuppressive medications or other therapies may be necessary to reduce the risk of future miscarriage.
By understanding the autoimmune factors that contribute to miscarriage, we can develop more effective treatments and improve outcomes for women with recurrent pregnancy loss.
Dr Manisha Singh (MBBS, DGO, DNBE, MD (Ob & Gynae), FRCOG, Doctorate Reproductive Medicine (UK)) is an Additional Director, Senior Consultant Gynaecologist & Subspecialist in Reproductive Medicine & Surgery at Fortis Hospital, Bannerghatta Road, Bangalore. She has an experience of over 32 years in Obstetrics, Gynaecology, Infertility and Assisted Conception treatments. Dr Manisha, commenced her training in Obstetrics & Gynaecology at KEM Hospital and was subsequently awarded the Doctorate of Medicine by the Mumbai University, followed by the award of DNBE by the National Board of Exams, New Delhi. She was then awarded the MRCOG, followed by CCST in 2005 with dual accreditation in Reproductive Medicine & Surgery (RCOG, UK). Later, she completed her Doctorate in Reproductive Medicine (DM) from University of Leeds (UK). She has been actively involved in both laboratory and clinical research in Reproductive Medicine and Surgery; still continues to be involved in PCOS and Endometriosis research. Apart from being a peer reviewer for over 20 reputed journals, she has contributed significantly to the medical fraternity with her publications on varied topics and also by presenting on various aspects of Reproductive Medicine & Surgery at different conferences/workshops. She has also authored many chapters on issues ranging from Menstrual Dysfunction, ART, and Gynaecological Ultrasound Postgraduate textbooks.