Assisted reproductive technologies for women with rheumatic AID

Lockshin, Michael D.

doi:10.1016/j.bpobgyn.2019.10.002

Cited by 8 publications

(4 citation statements)

References 42 publications

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“…An increasing number of studies have demonstrated that the administration of pregnancy-safe medications to reduce disease activity from the first trimester onwards can significantly reduce the rate of miscarriage, prevent the development of adverse fetal complications and improve the outcome of live births. [ 61 , 62 ] Hydroxychloroquine has been found to be an effective antiplatelet and immunomodulatory effects, [ 63 ] which improves hypercoagulability in RA circulation and reduces placental microthrombosis. [ 64 ] Other trials have demonstrated that low-molecular heparin and low-dose aspirin are up to 80% effective in improving live birth outcomes in pregnant women with RA, [ 65 ] and women with thrombotic manifestations require targeted anticoagulation to maintain homeostatic levels during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Causal association between rheumatoid arthritis and pregnancy loss and intrauterine growth retardation: A bidirectional two-sample Mendelian randomization study

Guo,

Diao,

Wang

et al. 2024

Medicine

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Objective: To investigate the causal relationship between rheumatoid arthritis (RA) and pregnancy loss and intrauterine growth retardation (IUGR) using Mendelian randomization (MR). Methods: Genetic variants associated with RA (12,555 cases and 240,862 controls), miscarriage (1475 cases and 149,622 controls), and IUGR (3558 cases and 207,312 controls) were obtained from the FinnGen consortium, and supplementary data on RA (5201 cases and 457,732 controls) and miscarriage (7069 cases and 250,492 controls) were obtained from the Medical Research Council Integrated Epidemiology Unit (MRC-IEU). 47 Single nucleotide polymorphisms (SNPs) associated with RA were screened as instrumental variables (IV). The causal relationship between RA and pregnancy loss and IUGR were assessed by 5 MR methods, mainly inverse variance weighting (IVW). Sensitivity analyses were also performed to test the stability of the results. Results: Bidirectional MR showed that genetically predicted RA was causally associated with pregnancy loss and IUGR in forward MR analyses, and that RA significantly increased pregnancy loss [odds ratio (OR) = 1.13, 95% confidence interval (CI): 1.00–1.33, P = .03] and IUGR (OR = 1.08, 95% CI: 1.01–1.15, P = .019). In the reverse MR, there was no causal association between pregnancy loss (P = .15) and IUGR (P = .87) and RA. Conclusion: This study found a significant genetic association between RA and pregnancy loss and IUGR. RA is considered to be a high-risk factor for adverse maternal outcomes. Pre-pregnancy prophylaxis and intra-pregnancy control of patients should be emphasized to reduce the incidence of adverse pregnancy outcomes such as pregnancy loss and IUGR.

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Section: Discussionmentioning

confidence: 99%

Causal association between rheumatoid arthritis and pregnancy loss and intrauterine growth retardation: A bidirectional two-sample Mendelian randomization study

Guo,

Diao,

Wang

et al. 2024

Medicine

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“…Active SLE, poorly controlled arterial hypertension, advanced renal disease, and major previous thrombotic events are situations in which ARTs should not be performed, due not only to the risks linked to ARTs but also to the subsequent pregnancy. As for spontaneous pregnancies, risk stratification and correct timing (at least 6 months of stable inactive disease and use of compatible medications) are key points for the prevention of maternal and obstetrical complications [61]. Although the prophylactic treatment during ARTs should be tailored for each patient, some general measures can be suggested.…”

Section: Assisted Reproduction Techniquesmentioning

confidence: 99%

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

Andréoli

Chighizola

Iaccarino

et al. 2023

Autoimmunity Reviews

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“…An exception is that subfertility is more common among patients who have been treated with cyclophosphamide [50,51]. Assisted reproductive technologies (ART) generally appear to be safe among people with well-controlled rheumatic diseases [52 ▪▪ ]. ART procedures include ovarian stimulation, which requires estrogens and other exogenous hormones; intrauterine insemination; in vitro fertilization; and embryo transfer [52 ▪▪ ].…”

Section: Fertility and Assisted Reproductionmentioning

confidence: 99%

“…Assisted reproductive technologies (ART) generally appear to be safe among people with well-controlled rheumatic diseases [52 ▪▪ ]. ART procedures include ovarian stimulation, which requires estrogens and other exogenous hormones; intrauterine insemination; in vitro fertilization; and embryo transfer [52 ▪▪ ]. As pregnancy is the intended outcome of ART, many of the factors that predict healthy pregnancies in SLE and SS—including quiescent disease and use of pregnancy-compatible medications—determine the optimal timing for ART.…”

Section: Fertility and Assisted Reproductionmentioning

confidence: 99%

Optimizing reproductive health management in lupus and Sjogren's syndrome

Talabi

Himes²,

Clowse

2021

Current Opinion in Rheumatology

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Purpose of reviewPeople with childbearing capacity who are diagnosed with systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS) have specific and important reproductive health considerations.Recent findingsRecommendations from the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) provide rheumatologists and other clinicians with guidance for reproductive health management of patients with rheumatic diseases. Patient-centered reproductive health counseling can help clinicians to operationalize the EULAR and ACR guidelines and enhance patient care.SummaryDisease activity monitoring, risk factor stratification, and prescription of pregnancy-compatible medications during pregnancy help to anticipate complications and enhance pregnancy outcomes in SLE and SS. Assisted reproductive technologies are also safe among people with well-controlled disease. Safe and effective contraceptive methods are available for patients with SLE and SS, and pregnancy termination appears to be safe among these patients.

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Assisted reproductive technologies for women with rheumatic AID

Cited by 8 publications

References 42 publications

Causal association between rheumatoid arthritis and pregnancy loss and intrauterine growth retardation: A bidirectional two-sample Mendelian randomization study

Causal association between rheumatoid arthritis and pregnancy loss and intrauterine growth retardation: A bidirectional two-sample Mendelian randomization study

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

Optimizing reproductive health management in lupus and Sjogren's syndrome

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