Proceedings From the American College of Rheumatology Reproductive Health Summit: The Management of Fertility, Pregnancy, and Lactation in Women With Autoimmune and Systemic Inflammatory Diseases

Most autoimmune and systemic inflammatory diseases are more common in women than in men, including women of child-bearing age. Therefore, for many of our patients, family planning is an important clinical issue. The management of pregnancy in autoimmune diseases is complex, benefitting optimally from a multidisciplinary approach that takes into consideration: prepregnancy counseling; treatments received prior to, during, and after pregnancy; early recognition of both obstetric complications and medical complications relating to the underlying disease; prenatal fetal development; and postnatal management of the

[1]  Lynda L. McGhie,et al.  Health Insurance Portability and Accountability Act (HIPAA) , 2011, Encyclopedia of Information Assurance.

[2]  J. Laven,et al.  Fertility in women with rheumatoid arthritis: influence of disease activity and medication , 2014, Annals of the rheumatic diseases.

[3]  Meghan T. Frey,et al.  Developing a systematic approach to safer medication use during pregnancy: summary of a Centers for Disease Control and Prevention--convened meeting. , 2014, American journal of obstetrics and gynecology.

[4]  Christopher F. Martin,et al.  960 Exposure to Anti-TNFα Therapy in the Third Trimester of Pregnancy Is Not Associated With Increased Adverse Outcomes: Results From the PIANO Registry , 2014 .

[5]  Christopher F. Martin,et al.  1 Achievement of Developmental Milestones Among Offspring of Women With Inflammatory Bowel Disease: The PIANO Registry , 2014 .

[6]  Christopher F. Martin,et al.  2 Pregnancy Outcomes Amongst Mothers With Inflammatory Bowel Disease Exposed to Systemic Corticosteroids: Results of the PIANO Registry , 2014 .

[7]  M. Østensen.  Safety issues of biologics in pregnant patients with rheumatic diseases , 2014 .

[8]  J. Hazes,et al.  Disease activity or remission of rheumatoid arthritis before, during and following pregnancy , 2014, Current opinion in rheumatology.

[9]  M. Clowse,et al.  Fertility and infertility in rheumatoid arthritis , 2014, Current opinion in rheumatology.

[10]  G. Koren,et al.  Pregnancy Outcome After Methotrexate Treatment for Rheumatic Disease Prior to or During Early Pregnancy: A Prospective Multicenter Cohort Study , 2014, Arthritis & rheumatology.

[11]  K. Salvesen,et al.  Rheumatoid arthritis and outcomes in first and subsequent births based on data from a national birth registry , 2014, Acta obstetricia et gynecologica Scandinavica.

[12]  Caroline Gordon,et al.  Population‐Based Incidence and Prevalence of Systemic Lupus Erythematosus: The Michigan Lupus Epidemiology and Surveillance Program , 2014, Arthritis & rheumatology.

[13]  Gina M. Prescott,et al.  Long‐Acting Reversible Contraception: A Review in Special Populations , 2014, Pharmacotherapy.

[14]  M. Ostensen.  Safety issues of biologics in pregnant patients with rheumatic diseases. , 2014, Annals of the New York Academy of Sciences.

[15]  J. Piette,et al.  Study of anti-Müllerian hormone and its relation to the subsequent probability of pregnancy in 112 patients with systemic lupus erythematosus, exposed or not to cyclophosphamide. , 2013, The Journal of clinical endocrinology and metabolism.

[16]  C. Gordon,et al.  In Utero Azathioprine Exposure and Increased Utilization of Special Educational Services in Children Born to Mothers With Systemic Lupus Erythematosus , 2013, Arthritis care & research.

[17]  C. Nelson-Piercy,et al.  Breastfeeding and tacrolimus: serial monitoring in breast-fed and bottle-fed infants. , 2013, Clinical journal of the American Society of Nephrology : CJASN.

[18]  M. Dubinsky,et al.  Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. , 2013, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[19]  G. Koren,et al.  The fetal safety of thiopurines for the treatment of inflammatory bowel disease in pregnancy , 2013, Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology.

[20]  D. Mattison.  Clinical pharmacology during pregnancy , 2013 .

[21]  S. Yaffe,et al.  Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice , 2012 .

[22]  S. Curtin,et al.  Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990-2008. , 2012, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[23]  K. Michaud,et al.  Effects of infertility, pregnancy loss, and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus , 2012, Arthritis care & research.

[24]  M. Clementi,et al.  Teratogenicity of mycophenolate confirmed in a prospective study of the European Network of Teratology Information Services , 2012, American journal of medical genetics. Part A.

[25]  Martha Ganser,et al.  Ovarian Damage During Chemotherapy in Autoimmune Diseases: Broad Health Implications beyond Fertility , 2012, Clinical medicine insights. Reproductive health.

[26]  C. Pineau,et al.  A population-based assessment of live births in women with systemic lupus erythematosus , 2011, Annals of the rheumatic diseases.

[27]  M. Carneiro-Sampaio,et al.  IgG Placental Transfer in Healthy and Pathological Pregnancies , 2011, Clinical & developmental immunology.

[28]  R. Eliakim,et al.  Detection of infliximab in breast milk of nursing mothers with inflammatory bowel disease. , 2011, Journal of Crohn's & colitis.

[29]  L. Finer,et al.  Unintended pregnancy in the United States: incidence and disparities, 2006. , 2011, Contraception.

[30]  Sonia Hernández-Díaz,et al.  Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. , 2011, American journal of obstetrics and gynecology.

[31]  S. Hernández-Díaz,et al.  Patterns of medication use during pregnancy in rheumatoid arthritis , 2011, Arthritis care & research.

[32]  W. Reinisch,et al.  Long-term follow-up of babies exposed to azathioprine in utero and via breastfeeding. , 2011, Journal of Crohn's & colitis.

[33]  G. Hankins,et al.  The Placenta as a Functional Barrier to Fetal Drug Exposure , 2011 .

[34]  D. Symmons,et al.  Anti-TNF therapies and pregnancy: outcome of 130 pregnancies in the British Society for Rheumatology Biologics Register , 2011, Annals of the rheumatic diseases.

[35]  S. Shariq,et al.  Case Report: Fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn's disease. , 2010, Journal of Crohn's & colitis.

[36]  C. Nielsen,et al.  Etanercept concentrations in maternal serum, umbilical cord serum, breast milk and child serum during breastfeeding. , 2010, Rheumatology.

[37]  G. Koren,et al.  Prenatal exposure to mycophenolate mofetil: an updated estimate. , 2010, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[38]  G. Wolbink,et al.  Correction: Predictors of damage and survival in patients with Wegener's granulomatosis: Analysis of 50 patients. , 2010, The Journal of Rheumatology.

[39]  S. Ben-Horin,et al.  Adalimumab level in breast milk of a nursing mother. , 2010, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[40]  R. Xu,et al.  Birth outcomes in women who have taken leflunomide during pregnancy. , 2010, Arthritis and rheumatism.

[41]  E. Chakravarty,et al.  Immunosuppressive Medications during Pregnancy and Lactation in Women with Autoimmune Diseases , 2010, Women's health.

[42]  S. Constantinescu,et al.  Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. , 2003, Clinical transplants.

[43]  H. Saito,et al.  Etanercept during pregnancy and lactation in a patient with rheumatoid arthritis: drug levels in maternal serum, cord blood, breast milk and the infant’s serum , 2009, Annals of the rheumatic diseases.

[44]  M. Carneiro-Sampaio,et al.  Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin , 2009, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[45]  C. Wagner,et al.  Absence of Infliximab in Infants and Breast Milk From Nursing Mothers Receiving Therapy for Crohn's Disease Before and After Delivery , 2009, Journal of clinical gastroenterology.

[46]  B. Paes,et al.  Outcomes of Late-Preterm Infants: A Retrospective, Single-Center, Canadian Study , 2009, Clinical pediatrics.

[47]  C. Gordon,et al.  Biologic therapy and pregnancy outcomes in women with rheumatic diseases. , 2009, Arthritis and rheumatism.

[48]  Hao W Zheng,et al.  Early School-Age Outcomes of Late Preterm Infants , 2009, Pediatrics.

[49]  R Todd Constable,et al.  Longitudinal Brain Volume Changes in Preterm and Term Control Subjects During Late Childhood and Adolescence , 2009, Pediatrics.

[50]  H. Osiovich,et al.  Perinatal Outcomes Associated With Preterm Birth at 33 to 36 Weeks’ Gestation: A Population-Based Cohort Study , 2009, Pediatrics.

[51]  S. Willemsen,et al.  Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study. , 2008, Arthritis and rheumatism.

[52]  E. Myers,et al.  A national study of the complications of lupus in pregnancy. , 2008, American journal of obstetrics and gynecology.

[53]  E. Chakravarty.  What we talk about when we talk about contraception. , 2008, Arthritis and rheumatism.

[54]  K. Leveno,et al.  Neonatal Mortality and Morbidity Rates in Late Preterm Births Compared With Births at Term , 2006, Obstetrics and gynecology.

[55]  D. Corley,et al.  Pregnancy outcomes in women with inflammatory bowel disease: a large community-based study from Northern California. , 2007, Gastroenterology.

[56]  B. Nørgård,et al.  Disease Activity in Pregnant Women With Crohn's Disease and Birth Outcomes: A Regional Danish Cohort Study , 2007, The American Journal of Gastroenterology.

[57]  G. Treacy,et al.  Effects of an Anti‐TNF‐α Monoclonal Antibody, Administered Throughout Pregnancy and Lactation, on the Development of the Macaque Immune System , 2007, American journal of reproductive immunology.

[58]  A. Hjern,et al.  Preterm Infants as Young Adults: A Swedish National Cohort Study , 2007, Pediatrics.

[59]  G. Lipscomb.  Medical therapy for ectopic pregnancy. , 2007, Seminars in reproductive medicine.

[60]  G. Koren,et al.  Breast-Feeding During Maternal Use of Azathioprine , 2006, The Annals of pharmacotherapy.

[61]  M. Cleves,et al.  National rates of birth defects among hospitalized newborns. , 2006, Birth defects research. Part A, Clinical and molecular teratology.

[62]  S. Targan,et al.  Case report: evidence for transplacental transfer of maternally administered infliximab to the newborn. , 2006, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[63]  R. Gearry,et al.  Exposure to thiopurine drugs through breast milk is low based on metabolite concentrations in mother-infant pairs. , 2006, British journal of clinical pharmacology.

[64]  K. Guthrie,et al.  Prospective study of fetal DNA in serum and disease activity during pregnancy in women with inflammatory arthritis. , 2006, Arthritis & Rheumatism.

[65]  E. Chakravarty,et al.  Obstetric hospitalizations in the United States for women with systemic lupus erythematosus and rheumatoid arthritis. , 2006, Arthritis and rheumatism.

[66]  E. Begg,et al.  Breastfeeding During Tacrolimus Therapy , 2006, Obstetrics and gynecology.

[67]  R. Brent,et al.  Diagnostic radiation in pregnancy: perception versus true risks. , 2006, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[68]  M. Genovese,et al.  Factors that predict prematurity and preeclampsia in pregnancies that are complicated by systemic lupus erythematosus. , 2005, American journal of obstetrics and gynecology.

[69]  A. Tincani,et al.  Follow-Up of Infants Exposed to Hydroxychloroquine Given to Mothers during Pregnancy and Lactation , 2005, Journal of Perinatology.

[70]  T. Spector,et al.  The role of pregnancy in the course and aetiology of rheumatoid arthritis , 1992, Clinical Rheumatology.

[71]  Reviewer Guidance Evaluating the Risks of Drug Exposure in Human Pregnancies , 2005 .

[72]  R. Cimaz,et al.  Electroretinograms of children born to mothers treated with hydroxychloroquine during pregnancy and breast-feeding: comment on the article by Costedoat-Chalumeau et al. , 2004, Arthritis and rheumatism.

[73]  G. Koren,et al.  Cyclosporine excretion into breast milk. , 2003, Transplantation.

[74]  G. Koren,et al.  Milk Transfer and Neonatal Safety of Tacrolimus , 2003, The Annals of pharmacotherapy.

[75]  G. Koren,et al.  Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis. , 2002, American journal of obstetrics and gynecology.

[76]  L. de Jong-van den Berg,et al.  Do Pregnant Women Report Use of Dispensed Medications? , 2001, Epidemiology.

[77]  B. Tura,et al.  Hydroxychloroquine (HCQ) in lupus pregnancy: double-blind and placebo-controlled study , 2001, Lupus.

[78]  S. Hernández-Díaz,et al.  Neural tube defects in relation to use of folic acid antagonists during pregnancy. , 2001, American journal of epidemiology.

[79]  E. Bond,et al.  BREAST‐FEEDING BY A CYCLOSPORINE‐TREATED MOTHER , 2001, Obstetrics and gynecology.

[80]  T. Einarson,et al.  Pregnancy outcome after cyclosporine therapy during pregnancy: a meta-analysis. , 2001, Transplantation.

[81]  M. Moritz,et al.  Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. , 2003, Clinical transplants.

[82]  T. Einarson,et al.  Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. , 2000, Teratology.

[83]  M. Bonati,et al.  Pregnancy Outcome Following Gestational Exposure to Fluoroquinolones: a Multicenter Prospective Controlled Study , 1998, Antimicrobial Agents and Chemotherapy.

[84]  G. Nyberg,et al.  Breast-feeding during treatment with cyclosporine. , 1998, Transplantation.

[85]  K. Nicolaides,et al.  Evolution of Maternofetal Transport of Immunoglobulins During Human Pregnancy , 1996, American journal of reproductive immunology.

[86]  M. Evans,et al.  Fetal drug therapy. , 1993, The Western journal of medicine.

[87]  Anajane G. Smith,et al.  Maternal-fetal disparity in HLA class II alloantigens and the pregnancy-induced amelioration of rheumatoid arthritis. , 1993, The New England journal of medicine.

[88]  A. Atkinson,et al.  Pharmacokinetics of prednisolone transfer to breast milk , 1993, Clinical pharmacology and therapeutics.

[89]  D. Balaban,et al.  Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with low-dose heparin treatment. , 1992, American journal of obstetrics and gynecology.

[90]  G. Koren,et al.  Prevention of unnecessary pregnancy terminations by counselling women on drug, chemical, and radiation exposure during the first trimester. , 1990, Teratology.

[91]  G. Koren,et al.  Perception of teratogenic risk by pregnant women exposed to drugs and chemicals during the first trimester. , 1989, American journal of obstetrics and gynecology.

[92]  G. Järnerot,et al.  Sulphasalazine and Sulphapyridine Serum Levels in Children to Mothers Treated with Sulphasalazine during Pregnancy and Lactation , 1987, Acta paediatrica Scandinavica.

[93]  E. Kerem,et al.  Bloody diarrhea--a possible complication of sulfasalazine transferred through human breast milk. , 1986, Journal of pediatric gastroenterology and nutrition.

[94]  J. Gschwend,et al.  Excretion of ibuprofen into breast milk. , 1984, American journal of obstetrics and gynecology.

[95]  Opie Lh.  Drugs and the heart. V. Digitalis and sympathomimetic stimulants. , 1980 .

[96]  J. Durodola.  Administration of cyclophosphamide during late pregnancy and early lactation: a case report. , 1979, Journal of the National Medical Association.

[97]  G. Järnerot,et al.  Sulphasalazine treatment during breast feeding. , 1979, Scandinavian journal of gastroenterology.

[98]  A. Breckenridge,et al.  May mothers given warfarin breast-feed their infants? , 1977, British medical journal.

[99]  D. Amato,et al.  NEUTROPENIA FROM CYCLOPHOSPHAMIDE IN BREAST MILK , 1977, The Medical journal of Australia.

[100]  Katz Fh,et al.  Letter: Entry of prednisone into human milk. , 1975 .

[101]  F. Katz,et al.  Entry of prednisone into human milk , 1975 .

[102]  C. Vogel,et al.  Secretion of methotrexate into human milk. , 1972, American journal of obstetrics and gynecology.

[103]  P. Wiernik,et al.  Cyclophosphamide in human milk. , 1971, Lancet.