Management of pregnancy in women with rheumatoid arthritis

Ngian, Gene-Siew; Briggs, Andrew M; Ackerman, Ilana N; Van Doornum, Sharon

doi:10.5694/mja15.00365

Topics

Women's health

Pharmaceutical preparations

Summary

Rheumatoid arthritis (RA) disease activity may improve during pregnancy but postpartum flares are common.
Patients taking disease-modifying antirheumatic drugs should be counselled about effective contraception.
Knowledge about drug safety in pregnancy is limited but the Therapeutic Goods Administration categories and online resources are a guide to the data currently available.
Begin prepregnancy counselling as early as possible to allow for cessation of teratogenic medications and optimisation of RA disease control.
For unplanned pregnancies, cease teratogenic medications immediately and refer to a genetic counsellor and maternal–fetal medicine specialist for risk assessment and advice.

1 Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC
2 Arthritis and Osteoporosis Victoria, Research and Knowledge, Melbourne, VIC
3 Melbourne EpiCentre, Melbourne Health and University of Melbourne, Melbourne, VIC

Correspondence: gene-siew.ngian@mh.org.au

Competing interests:

This was an investigator-initiated review, but we received research grants from UCB and AbbVie. Neither company had any input into the design or execution of our review.

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