Pregnancy

How does inflammatory myositis affect fertility and pregnancy? There is limited data about pregnancy in these patients. Active disease, especially in early pregnancy, is associated with adverse outcomes. Patients with new onset of poly/dermatomyositis during pregnancy have a high risk of fetal loss. The most common complications are preterm delivery and infants born small for […]

How does systemic sclerosis affect fertility and pregnancy complications? • Fertility is unaffected. • Pulmonary hypertension is a contraindication to pregnancy. • Women with early disease should delay pregnancy until disease stabilization. • Increased risk: (1) preterm delivery, (2) intrauterine growth restriction, and (3) low birth weight. • Risk factors for worse outcomes: (1) early disease, (2) diffuse cutaneous SSc,

What effect does pregnancy have on the spondyloarthropathies and vice versa? • Fertility is unaffected. • The course of ankylosing spondylitis varies during pregnancy (33% improve, 33% worsen) and up to 60% worsen postpartum (mostly low back pain). • Newer data suggests that women may have increased risk of cesarean section, preterm birth, and infants born small for gestational

How does APS affect pregnancy outcomes? How it is best treated? • Patients with APS with or without SLE are at risk for poor pregnancy outcomes (OR 9.2) including intrauterine growth restriction (OR 4.7), preeclampsia (OR 2.3), thrombosis (OR 12.1), and early and late fetal loss. • A systematic review found that for recurrent early miscarriage associated

How does pregnancy affect Rheumatoid Arthritis? • Two-thirds of patients with RA have improvement in RA symptoms during pregnancy, but <20% achieve drug-free remission. • Symptom improvement is highest during the third trimester. • Two-thirds of RA patients have a flare of RA symptoms in the first 6 months postpartum. • Erythrocyte sedimentation rate increases during pregnancy and should

What is pregnancy associated APS? What are the criteria for pregnancy associated APS? Patients can have primary or secondary pregnancy-associated APS. Those with primary disease do not have an associated autoimmune disease. Those with secondary APS can have numerous autoimmune diseases, although SLE is likely the most common. • All patients must have: repeatedly positive aPLAs (twice

Which lupus related autoantibodies can cause problems for a fetus during pregnancy? Antibodies to Ro/SSA, especially when directed against the 52-kD component, have been associated with neonatal lupus syndrome. This can also occur in any woman who makes these antibodies regardless of whether she has autoimmune disease or not. Antibodies to La/SSB have also less commonly been associated