Neurological involvement and pregnancy outcomes in autoimmune disease: mechanisms, clinical implications, and research gaps.

Tal Friedman Korn, Giovanna S Manzanno, Mattia Wruble Clark, Shamik Bhattacharyya, Maria K Houtchens

Abstract readReview

In one paragraph

Review in Rheumatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tal Friedman KornDepartment of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA, USA. tfriedman-korn@bwh.harvard.edu.ORCID http://orcid.org/0009-0002-3825-4391

Giovanna S ManzannoDepartment of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-9991-9222

Mattia Wruble ClarkDepartment of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0009-0009-1572-251X

Shamik BhattacharyyaDepartment of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-8047-3622

Maria K HoutchensDepartment of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-6077-0654

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pregnancy in systemic autoimmune diseases is associated with increased maternal and fetal morbidity, yet the specific impact of neurological involvement remains poorly characterized. This review synthesizes pregnancy outcomes in systemic lupus erythematosus (SLE), Sjögren's syndrome, sarcoidosis, and Behçet's disease, focusing on neurological manifestations. A narrative review (2010-2025) was conducted via PubMed/MEDLINE. Observational cohorts, registries, and systematic reviews reporting maternal, fetal, and neonatal outcomes were included. Across autoimmune conditions, pregnancy risks are significantly elevated, most pronounced in SLE. Meta-analyses in SLE reported preeclampsia rates of 2-35%, preterm birth in 14.7-50%, and fetal loss up to 21.7%. In sarcoidosis, studies showed increased risks of preeclampsia (OR 1.62) and preterm delivery (OR 1.73), while Sjögren's syndrome was associated with congenital heart block in up to 17.9% of at-risk pregnancies. Neurological manifestations are frequently documented but rarely analyzed as independent risk factors; in one study, neuropsychiatric lupus was associated with higher rates of maternal (38.1% vs 14.1%) and fetal complications, although evidence remains limited and should be interpreted with caution. Neurological involvement is a critical but under-studied dimension of pregnancy risk. Improved phenotyping, multidisciplinary care, and prospective registries are needed to optimize risk stratification and maternal-fetal management.

Indexed as

Autoimmune DiseasesNervous System DiseasesPregnancy ComplicationsEvidence GapsFemaleHumansObservational Studies as TopicPregnancyPregnancy OutcomeRisk FactorsSystematic Reviews as TopicAutoimmune diseasesBehçet diseaseFetal outcomesMaternal outcomesNeuroimmunologyNeurological manifestationsNeuropsychiatric lupusPregnancyPregnancy complicationsSarcoidosisSjögren’s syndromeSystemic lupus erythematosus

Identifiers

PMID42176218

DOI10.1007/s00296-026-06152-x

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.