Immunology of pregnancy and reproductive health in autoimmune rheumatic diseases. Update from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases

被引：19

作者：

Andreoli, Laura ^{[1
,2
]}

Chighizola, Cecilia B. ^{[3
]}

Iaccarino, Luca ^{[4
]}

Botta, Angela ^{[5
]}

Gerosa, Maria ^{[6
]}

Ramoni, Veronique ^{[7
]}

Tani, Chiara ^{[8
,9
]}

Bermas, Bonnie ^{[10
]}

Brucato, Antonio ^{[11
,12
]}

Buyon, Jill ^{[13
]}

Cetin, Irene ^{[12
,14
,15
]}

Chambers, Christina D. ^{[16
]}

Clowse, Megan E. B. ^{[17
]}

Costedoat-Chalumeau, Nathalie ^{[18
]}

Cutolo, Maurizio ^{[19
,20
]}

De Carolis, Sara ^{[5
]}

Dolhain, Radboud ^{[21
]}

Fazzi, Elisa M. ^{[2
,22
]}

Foerger, Frauke ^{[23
,24
]}

Giles, Ian ^{[25
]}

Haase, Isabell ^{[26
,27
]}

Khamashta, Munther ^{[28
,42
]}

Levy, Roger A. ^{[29
,43
]}

Meroni, Pier Luigi ^{[30
]}

Mosca, Marta ^{[8
,9
]}

Nelson-Piercy, Catherine ^{[31
]}

Raio, Luigi ^{[24
,32
]}

Salmon, Jane ^{[33
,34
]}

Villiger, Peter ^{[35
]}

Wahren-Herlenius, Marie ^{[36
]}

Wallenius, Marianne ^{[37
,38
]}

Zanardini, Cristina ^{[39
]}

Shoenfeld, Yehuda ^{[40
,41
]}

Tincani, Angela ^{[1
,2
]}

机构：

[1] ASST Spedali Civili, Rheumatol & Clin Immunol Unit, Piazzale Spedali Civili 1, I-25123 Brescia, Italy

[2] Univ Brescia, Dept Clin & Expt Sci, Brescia, Italy

[3] Univ Milan, Dept Clin Sci & Community Hlth, Paediat Rheumatol Unit, ASST G Pini & CTO, Milan, Italy

[4] Univ Padua, Dept Med DIMED, Rheumatol Unit, Padua, Italy

[5] Fdn Policlin Univ A Gemelli IRCCS, Dept Obstet Gynaecol & Pediat, Rome, Italy

[6] Univ Milan, Res Ctr Adult & Pediat Rheumat Dis, ASST Gaetano Pini CTO, Div Clin Rheumatol,Dept Clin Sci & Community Hlth, Milan, Italy

[7] ASST Lodi Osped Maggiore, Med Gen Lodi, Lodi, Italy

[8] Univ Pisa, Azienda Osped Univ Pisana, Rheumatol Unit, Pisa, Italy

[9] Univ Pisa, Dept Clin & Expt Med, Pisa, Italy

[10] UT Southwestern Med Ctr, Dallas, TX USA

[11] Fatebenefratelli Hosp, Internal Med, Milan, Italy

[12] Univ Milan, Dept Biomed & Clin Sci, Milan, Italy

[13] NYU, Grossman Sch Med, Div Rheumatol, New York, NY USA

[14] ASST Fatebenefratelli Sacco, Luigi Sacco Hosp, Dept Woman Mother & Child, Milan, Italy

[15] ASST Fatebenefratelli Sacco, Vittore Buzzi Children Hosp, Milan, Italy

[16] Univ Calif San Diego, Herbert Wertheim Sch Publ Hlth & Longev Sci, Dept Pediat, La Jolla, CA 92093 USA

[17] Duke Univ, Sch Med, Div Rheumatol & Immunol, Durham, NC USA

[18] Univ Paris, Cochin Hosp, Referral Ctr Rare Autoimmune & Syst Dis, INRA,Internal Med Dept,CRESS,INSERM, Paris, France

[19] Univ Genoa, IRCSS San Martino Polyclin, Dept Internal Med, Lab Expt Rheumatol, Genoa, Italy

[20] Univ Genoa, IRCSS San Martino Polyclin, Dept Internal Med, Acad Div Clin Rheumatol, Genoa, Italy

[21] Erasmus MC, Dept Rheumatol, Rotterdam, Netherlands

[22] ASST Spedali Civili, Child Neurol & Psychiat Unit, Brescia, Italy

[23] Univ Hosp, Inselspital, Dept Rheumatol & Immunol, Bern, Switzerland

[24] Univ Bern, Bern, Switzerland

[25] UCL, Univ Coll London Hosp, Ctr Rheumatol, Dept Inflammat,Div Med,Dept Rheumatol, London, England

[26] Heinrich Heine Univ, Dept Rheumatol, Dusseldorf, Germany

[27] Heinrich Heine Univ, Hiller Res Inst, Dusseldorf, Germany

[28] Kings Coll London, Women & Childrens Hlth, London, England

[29] Univ Estado Rio de Janeiro, Rio De Janeiro, Brazil

[30] IRCCS Ist Auxol Italiano, Immunorheumatol Res Lab, Milan, Italy

[31] Guys & St Thomas Hosp, Dept Obstet & Gynaecol, London, England

[32] Univ Hosp, Inselspital, Dept Obstet & Gynaecol, Bern, Switzerland

[33] Hosp Special Surg, Dept Med, Div Rheumatol, 535 E 70th St, New York, NY 10021 USA

[34] Weill Cornell Med, New York, NY USA

[35] Med Ctr Monbijou, Rheumatol & Clin Immunol, Bern, Switzerland

[36] Karolinska Inst, Karolinska Univ Hosp, Dept Med, Stockholm, Sweden

[37] Trondheim Reg & Univ Hosp, St Olavs Hosp, Natl Advisory Unit Pregnancy & Rheumat Dis, Trondheim, Norway

[38] Norwegian Univ Sci & Technol, Inst Neuromed & Movement Sci, NTNU, Trondheim, Norway

[39] ASST Spedali Civili, Dept Obstet & Gynecol, Brescia, Italy

[40] Ariel Univ, Sackler Fac Med, Ariel, Israel

[41] Sheba Med Ctr, Zabludowicz Ctr Autoimmune Dis, Tel Hashomer, Israel

[42] GlaxoSmithKline Global Med Expert, Dubai, U Arab Emirates

[43] GlaxoSmithKline Global Med Expert, Collegeville, PA USA

来源：

AUTOIMMUNITY REVIEWS | 2023年 / 22卷 / 03期

关键词：

Pregnancy; Rheumatic diseases; Anti-rheumatic drugs; Reproductive health; Fertility; Contraception; Assisted reproduction techniques; SYSTEMIC-LUPUS-ERYTHEMATOSUS; JUVENILE IDIOPATHIC ARTHRITIS; ANTI-MULLERIAN HORMONE; ANTIPHOSPHOLIPID SYNDROME; BEHCETS-DISEASE; EULAR RECOMMENDATIONS; ASSISTED REPRODUCTION; ANTIRHEUMATIC DRUGS; OVARIAN RESERVE; CHILDREN BORN;

D O I：

10.1016/j.autrev.2022.103259

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Autoimmune rheumatic diseases (ARD) can affect women and men during fertile age, therefore reproductive health is a priority issue in rheumatology. Many topics need to be considered during preconception counselling: fertility, the impact of disease-related factors on pregnancy outcomes, the influence of pregnancy on disease activity, the compatibility of medications with pregnancy and breastfeeding. Risk stratification and individualized treatment approach elaborated by a multidisciplinary team minimize the risk of adverse pregnancy outcomes (APO). Research has been focused on identifying biomarkers that can be predictive of APO. Specifically, preeclampsia and hypertensive disorders of pregnancy tend to develop more frequently in women with ARD. Placental insufficiency can lead to intrauterine growth restriction and small-for-gestational age newborns. Such APO have been shown to be associated with maternal disease activity in different ARD. Therefore, a key message to be addressed to the woman wishing for a pregnancy and to her family is that treatment with compatible drugs is the best way to ensure maternal and fetal wellbeing. An increasing number of medications have entered the management of ARD, but data about their use in pregnancy and lactation are scarce. More information is needed for most biologic drugs and their biosimilars, and for the so-called small molecules, while there is sufficient evidence to recommend the use of TNF inhibitors if needed for keeping maternal disease under control. Other issues related to the reproductive journey have emerged as "unmet needs", such as sexual dysfunction, contraception, medically assisted reproduction techniques, long-term outcome of children, and they will be addressed in this review paper. Collaborative research has been instrumental to reach current knowledge and the future will bring novel insights thanks to pregnancy registries and prospective studies that have been established in several Countries and to their joint efforts in merging data.

引用

页数：21

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