Preconception planning is essential to help women with autoimmune disease have optimal pregnancy outcomes. Unplanned pregnancy can also negatively impact disease course in some patients. Yet many rheumatologic patients of childbearing age do not receive adequate contraception or prepregnancy education and counseling. Rheumatologists must work collaboratively with other healthcare providers to make sure rheumatic patients…
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Rheumatology Case Report: Monoarticular Arthritis in Pregnancy
Limited data exist on the clinical presentation of Muckle–Wells syndrome (MWS) during pregnancy. The purpose of this case report is to highlight the diagnosis of MWS in a pregnant woman. Many rheumatic diseases affect women of childbearing age, and their management during pregnancy can be challenging. Case A 33-year-old, 18-weeks’ pregnant woman was hospitalized for…
Juvenile-Onset Arthritis Bodes Worse Pregnancy Outcomes
NEW YORK (Reuters Health)—Women with a diagnosis of juvenile idiopathic arthritis (JIA) are at increased risk of pregnancy complications, according to Swedish researchers. As Dr. Katarina Remaeus told Reuters Health by email, “In our cohort study . . . we found an association with adverse pregnancy outcomes including preterm birth, induction of labor and delivery…
Paternal Methotrexate Exposure Not Tied to Adverse Pregnancy Outcomes
NEW YORK (Reuters Health)—A father’s exposure to methotrexate 90 days or less before conception “should not be of major concern,” researchers say. Prepregnancy paternal methotrexate exposure appears to confer no increased risk of major or minor congenital malformation, stillbirth or preterm birth in his offspring, their study found. Methotrexate is a first-line therapy for rheumatoid…
Rheumatologists Should Discuss with Patients Use of Immunomodulatory Agents During Pregnancy
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…
Pregnancy Outcome in Early Rheumatic Disease
Systemic autoimmune rheumatic diseases are associated with increased rates of adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, fetal growth restriction (FGR) and prematurity. In this study population, preclinical rheumatic disorders were associated with an increased risk of FGR, preeclampsia and small-for-gestational-age infants. The impact of these findings and their utility in screening for fetal growth restriction/preeclampsia need to be confirmed in population studies…
Extra Bone Resorption in Pregnancy, Lactation May Pass Maternal Lead Burden to Baby
NEW YORK (Reuters Health)—Bone resorption increases during pregnancy and continues to be high postpartum, according to new findings using lead testing to measure bone turnover. Researchers also found unexpected evidence that maternal lead burden is transferred to the fetus. “These data confirm calcium balance studies that indicate increased bone resorption throughout pregnancy and lactation,” Dr….
Management Tips to Handle Pregnancy-Related Absences
We all know that completely different medical conditions can create the same effects on our patients’ work lives. That is, from the employer’s purely administrative standpoint, an absence is an absence regardless of its cause. Even medical care professionals react differently to similar effects rendered by completely different circumstances. A Personnel Crisis Let me give…
New Study Examines Pregnancy Risk Factors for Patients with Lupus
Important new findings show that a majority of women with inactive or stable SLE can have successful pregnancies without experiencing flares and give birth to infants who survive the neonatal period…
Rheumatoid Arthritis and Pregnancy
Research shows women with RA at risk of preterm birth
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