title: Contraception and pregnancy counselling in rheumatoid arthritis.
abstract: OBJECTIVE
  The purpose of this study is to encourage discussion of reproduction issues in all patients of fertile age in order to prevent unplanned and ill-timed pregnancies in patients with rheumatoid arthritis (RA).
  
  
  RESULTS
  Counselling patients who desire children requires consideration of relevant reproductive health issues, including fertility, interaction of pregnancy and RA, and management during pregnancy and lactation. RA patients have no disease-related restrictions in regard to contraception, but need to be counselled on safe birth control particularly during treatment with potentially teratogenic drugs. In spite of mostly beneficial effects of pregnancy on RA, active disease and aggressive drug treatment can impair pregnancy outcomes. Options for drug therapy, though limited, may help to maintain low disease activity during pregnancy and lactation.
  
  
  CONCLUSIONS
  Careful preconception counselling and risk assessment is important in RA women, with a particular focus on preventing unplanned pregnancy by information on contraception. Antibody status and all medications need to be reviewed before pregnancy. Maintaining low disease activity before and during pregnancy is crucial for good outcomes. Preconceptional counselling shared with all health professionals engaged in the care of a patient helps to ensure healthy pregnancy outcomes for mother and child.
authors.affiliation: National Center for Pregnancy and Rheumatic disease, Department of Rheumatology, University Hospital of Trondheim, Trondheim, Norway.
authors.forename: Monika
authors.initials: M
authors.lastname: Østensen
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003267:Contraception / Q000379:methods*; D003376:Counseling / Q000379:methods; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006801:Humans; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011256:Pregnancy Outcome; D049168:Pregnancy, Unplanned
chemical_list: D018501:Antirheumatic Agents