TY - JOUR
T1 - Pregnancy and reproduction in autoimmune rheumatic diseases
AU - Ostensen, Monika
AU - Brucato, Antonio
AU - Carp, Howard
AU - Chambers, Christina
AU - Dolhain, Radboud J. E. M.
AU - Doria, Andrea
AU - Foerger, Frauke
AU - Gordon, Caroline
AU - Hahn, Sinuhe
AU - Khamashta, Munther
AU - Lockshin, Michael D.
AU - Matucci-Cerinic, Marco
AU - Meroni, Pierluigi
AU - Nelson, J. Lee
AU - Parke, Ann
AU - Petri, Michelle
AU - Raio, Luigi
AU - Ruiz-Irastorza, Guillermo
AU - Silva, Clovis A.
AU - Tincani, Angela
AU - Villiger, Peter M.
AU - Wunder, Dorothea
AU - Cutolo, Maurizio
PY - 2011/4
Y1 - 2011/4
N2 - 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.
AB - 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.
U2 - 10.1093/rheumatology/keq350
DO - 10.1093/rheumatology/keq350
M3 - Literature review
SN - 1662-3959
SN - 1462-0332
VL - 50
SP - 657
EP - 664
JO - Rheumatology
JF - Rheumatology
IS - 4
M1 - keq350
ER -