Pregnancy in dermatomyositis and polymyositis

AIM: To determine the incidence of pregnancies during the inflammatory myopathy (IM), its influence on this disease and the influence of IM on the pregnancy's outcome. METHODS: From 1979 to 2007 we have collected retrospectively 67cases of IM (53 women and 14 men) in the department of internal medicine CHU Hedi Chaker of Sfax (Tunisia). Diagnosis criteria were those and Peter. We have included pregnancies occurring after diagnosis of DM or PM and cases of IM occurring during pregnancy or postpartum. RESULTS: Five women (4DM and PM), average age 30.6 years (range 26 - 41 years) conducted 10 pregnancies (9.4%). The fertility rate is 2 pregnancies per patient. Nine pregnancies occurred after the diagnosis of myositis in 4 women. IM was inactive at conception in all this cas.No flare-up in IM has been noted during these pregnancies. The DM was revealed to the 10th day post-partum in one patient. Therapeutic interruption of pregnancy was needed in 3 cases. 4 pregnancies were completed without incident and resulted in the birth of healthy newborns. Foetal complications were observed in the other two pregnancies occurring in one patient who also presents an APS associated with DM. It was a foetal death in utero and premature delivery of a newborn who died in 3rd day after birth. CONCLUSION: Pregnancy in the MI is rare. Its influence on the activity of the disease is variable, both during the pregnancy than postpartum. The foetal prognosis is good when the the disease is in remission. However foetal complications are important in case of active IM.