Pre-existing autoimmune disease during pregnancy is infrequent occurring in 1.0-2.0% of
pregnant women. Autoimmune diseases (ADs) are not lethal and can co-exist with other autoimmune
types. In the present report, ADs were found to produce false positive maternal serum screens for both
neural tube defects and Down syndrome. The course of ADs is highly influenced by maternal and
placental proteins, hormonal factors, and cytokines. Such agents appear to serve as protective factors at
the induction and effector stages of the immune response during pregnancy. During second and third
trimester pregnancies and in postpartum, autoimmune-afflicted patients experience stages of remissions
and relapses. Most remissions occur in the second and third trimesters when soluble immunoprotective
factors attain peak levels. Some plausible immunosuppressive factors include quad biomarkers and
pregnancy associated glycoproteins such as alpha-fetoprotein, human chorionic gonadotrophin, dimeric
inhibin-A, and unconjugated Estriol. The mechanism of remission of ADs is not fully understood but is
associated with induction of an immunosuppressive and/or immunotolerant state coincident with the
presence of known and unknown soluble factors.
Keywords: Alpha-fetoprotein, autoimmunity, dimeric inhibin, human chorionic gonadotrophin, pregnancy, unconjugated Estriol.
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