Pregnancy and reproduction in autoimmune rheumatic diseases

Monika Østensen, Antonio Brucato, Howard Carp, Christina Chambers, Radboud J.E.M. Dolhain, Andrea Doria, Frauke Förger, Caroline Gordon, Sinuhe Hahn, Munther Khamashta, Michael D. Lockshin, Marco Matucci-Cerinic, Pierluigi Meroni, J. Lee Nelson, Ann Parke, Michelle Petri, Luigi Raio, Guillermo Ruiz-Irastorza, Clovis A. Silva, Angela TincaniPeter M. Villiger, Dorothea Wunder, Maurizio Cutolo

Research output: Contribution to journalReview article

Abstract

Despite evidence for the important role of oestrogens in the aetiology and pathophysiology of chronic immune/inflammatory diseases, the previous view of an unequivocal beneficial effect of oestrogens on RA compared with a detrimental effect on SLE has to be reconsidered. Likewise, the long-held belief that RA remits in the majority of pregnant patients has been challenged, and shows that only half of the patients experience significant improvement when objective disease activity measurements are applied. Pregnancies in patients with SLE are mostly successful when well planned and monitored interdisciplinarily, whereas a small proportion of women with APS still have adverse pregnancy outcomes in spite of the standard treatment. New prospective studies indicate better outcomes for pregnancies in women with rare diseases such as SSc and vasculitis. Fertility problems are not uncommon in patients with rheumatic disease and need to be considered in both genders. Necessary therapy, shortly before or during the pregnancy, demands taking into account the health of both mother and fetus. Long-term effects of drugs on offspring exposed in utero or during lactation is a new area under study as well as late effects of maternal rheumatic disease on children.

Original languageEnglish (US)
Article numberkeq350
Pages (from-to)657-664
Number of pages8
JournalRheumatology
Volume50
Issue number4
DOIs
StatePublished - Apr 1 2011

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Keywords

  • Antiphospholipid syndrome
  • Fertility
  • Neonatal lupus
  • Oestrogen
  • Pre-eclampsia
  • Pregnancy
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Systemic sclerosis
  • Vasculitis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

Østensen, M., Brucato, A., Carp, H., Chambers, C., Dolhain, R. J. E. M., Doria, A., Förger, F., Gordon, C., Hahn, S., Khamashta, M., Lockshin, M. D., Matucci-Cerinic, M., Meroni, P., Nelson, J. L., Parke, A., Petri, M., Raio, L., Ruiz-Irastorza, G., Silva, C. A., ... Cutolo, M. (2011). Pregnancy and reproduction in autoimmune rheumatic diseases. Rheumatology, 50(4), 657-664. [keq350]. https://doi.org/10.1093/rheumatology/keq350