Autoimmune Bullous Diseases In Pregnancy: A Systematic Review Of Clinical Presentation, Management, And Outcomes
Keywords:
Clinical Presentation, Autoimmune, Pregnancy, Management, OutcomesAbstract
Background: Autoimmune bullous diseases during pregnancy are rare but clinically significant conditions that require special attention due to pregnancy-related immunological changes and the potential risk of maternal and fetal complications. Objective: This systematic review aimed to summarize the clinical characteristics, management strategies, and maternal–fetal outcomes of autoimmune bullous diseases occurring during pregnancy. Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, Web of Science, Embase, and the Cochrane Library for studies published between January 2021 and January 2025. From the 309 articles initially identified, 10 studies met the inclusion criteria and were included in the qualitative synthesis. Results: Pemphigoid gestationis was the most frequently reported autoimmune bullous disease, with disease onset predominantly occurring during the second to third trimester of pregnancy. Clinical manifestations varied widely, ranging from mild localized lesions to generalized bullous eruptions. Systemic and topical corticosteroids were the mainstay of treatment and were associated with favorable maternal outcomes in most cases. Reported maternal complications included intrauterine growth restriction (33%), oligohydramnios, and gestational hypertension. Neonatal involvement was observed in approximately 10–17% of cases and was generally self-limiting with a good prognosis. Conclusions: The management of autoimmune bullous diseases during pregnancy requires a multidisciplinary approach to optimize both maternal and fetal outcomes. However, current evidence remains limited, highlighting the need for further studies to establish standardized and evidence-based management protocols.
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