title: Pregnancy and reproduction in autoimmune rheumatic diseases.
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.
authors.affiliation: Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, CH-3010 Bern, Switzerland. monika.ostensen@gmail.com
authors.forename: Monika
authors.initials: M
authors.lastname: Ostensen
authors.forename: Antonio
authors.initials: A
authors.lastname: Brucato
authors.forename: Howard
authors.initials: H
authors.lastname: Carp
authors.forename: Christina
authors.initials: C
authors.lastname: Chambers
authors.forename: Radboud J E M
authors.initials: RJ
authors.lastname: Dolhain
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
authors.forename: Frauke
authors.initials: F
authors.lastname: Förger
authors.forename: Caroline
authors.initials: C
authors.lastname: Gordon
authors.forename: Sinuhe
authors.initials: S
authors.lastname: Hahn
authors.forename: Munther
authors.initials: M
authors.lastname: Khamashta
authors.forename: Michael D
authors.initials: MD
authors.lastname: Lockshin
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Meroni
authors.forename: J Lee
authors.initials: JL
authors.lastname: Nelson
authors.forename: Ann
authors.initials: A
authors.lastname: Parke
authors.forename: Michelle
authors.initials: M
authors.lastname: Petri
authors.forename: Luigi
authors.initials: L
authors.lastname: Raio
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ruiz-Irastorza
authors.forename: Clovis A
authors.initials: CA
authors.lastname: Silva
authors.forename: Angela
authors.initials: A
authors.lastname: Tincani
authors.forename: Peter M
authors.initials: PM
authors.lastname: Villiger
authors.forename: Dorothea
authors.initials: D
authors.lastname: Wunder
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cutolo
mesh_terms: D001327:Autoimmune Diseases / Q000503:physiopathology*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000503:physiopathology; D011256:Pregnancy Outcome; D012098:Reproduction / Q000502:physiology*; D012216:Rheumatic Diseases / Q000503:physiopathology*
chemical_list: D012739:Gonadal Steroid Hormones