title: Women's health and fertility, family planning and pregnancy in immune-mediated rheumatic diseases: a report from a south-eastern European Expert Meeting.
abstract: With current advances in medical treatment, reproductive issues have become more important for women with chronic immune-mediated diseases. Most, if not all, patients report that their disease affects their personal relationships, their decision to have children, and the size of their family. These decisions are multi-factorial, influenced mainly by concerns over the effect of pregnancy on the rheumatic disease, the impact of disease activity during pregnancy on foetal health, the patient's ability to care for the child, and the possible harmful effects medication could have on the child, both pre- and post-natally during breastfeeding. Apart from that, women's health issues tend to be overlooked in favour of the management of the underlying rheumatic disease. To this end, we convened an expert panel to review the published literature on women's health and reproductive issues and provide evidence- and eminence-based points to consider for the treating physicians. We conclude that there is a need for a change in mind-set from one which 'cautions against pregnancy' to one which 'embraces pregnancy' through the practice of individualised, pre- and post-conceptual, multi-disciplinary care.
authors.affiliation: Department of Internal Medicine, Ippokrateio General Hospital of Thessaloniki, Greece. stelladali@gmail.com.
authors.forename: Stella
authors.initials: S
authors.lastname: Ntali
authors.forename: Nemanja
authors.initials: N
authors.lastname: Damjanov
authors.forename: Peter
authors.initials: P
authors.lastname: Drakakis
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Ionescu
authors.forename: Desislava
authors.initials: D
authors.lastname: Kalinova
authors.forename: Rasho
authors.initials: R
authors.lastname: Rashkov
authors.forename: Ariadne
authors.initials: A
authors.lastname: Malamitsi-Puchner
authors.forename: Gerassimos
authors.initials: G
authors.lastname: Mantzaris
authors.forename: Lina
authors.initials: L
authors.lastname: Michala
authors.forename: Cristina
authors.initials: C
authors.lastname: Pamfil
authors.forename: Simona
authors.initials: S
authors.lastname: Rednic
authors.forename: Maria G
authors.initials: MG
authors.lastname: Tektonidou
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vassilopoulos
authors.forename: Jelena
authors.initials: J
authors.lastname: Vojinovic
authors.forename: George K
authors.initials: GK
authors.lastname: Bertsias
authors.forename: Dimitrios T
authors.initials: DT
authors.lastname: Boumpas
mesh_terms: D003226:Congresses as Topic; D005193:Family Planning Services / Q000379:methods; D005260:Female; D005298:Fertility; D059247:Fertility Preservation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007247:Infertility, Female / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D012216:Rheumatic Diseases / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D016387:Women's Health
chemical_list: D007166:Immunosuppressive Agents