#2-69E. Optimizing Pregnancy Outcomes in Autoimmune Rheumatic Diseases (AR, 2023)

When consulting female patients with Autoimmune Rheumatic Diseases (ARD) who wish to conceive, how do you balance effective disease control with fetal safety and minimize the risk of adverse pregnancy outcomes (APO)? This review summarizes critical updates from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases, emphasizing that comprehensive reproductive health counseling is a priority in rheumatology. The paper outlines the complexity of managing these high-risk pregnancies, detailing how disease activity, specific autoantibodies (e.g., aPL, anti-Ro/SSA), and drug compatibility influence outcomes, necessitating specialized preconception planning. The core message highlights that an individualized risk stratification by a multidisciplinary team and maintaining stable disease remission using pregnancy-compatible treatments, such as TNF inhibitors when necessary, are essential strategies for preventing APOs. Physicians should note, however, that the field still suffers from a lack of unbiased, rigorous data due to the inherent difficulty of conducting randomized controlled trials in pregnant populations. This comprehensive update provides the latest evidence and strategic approaches necessary to offer effective, individualized counseling and significantly improve maternal and fetal well-being in your complex ARD cases.

Citation: Andreoli L, Chighizola CB, Iaccarino L, et al. Immunology of pregnancy and reproductive health in autoimmune rheumatic diseases. Update from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases. Autoimmunity Reviews. 2023. DOI: 10.1016/j.autrev.2022.103259

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.