Fertility, pregnancy planning, and pharmacotherapy during the pregnancy, postpartum and breastfeeding period in patients with rheumatoid arthritis and other inflammatory arthropathies

Olesińska, Marzena; Ostanek, Lidia; Majdan, Maria; Kosowicz, Mariola; Teliga-Czajkowska, Justyna; Wiland, Piotr

doi:10.5114/reum.2014.41446

Cited by 2 publications

(2 citation statements)

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“…Numerous clinical reviews, guidelines, and observational studies have highlighted the need for provision of information on family planning early on following diagnosis, pre-conception counselling, co-ordination/joined-up care, and multi-disciplinary team involvement for women of reproductive age who have an autoimmune rheumatic disease [e.g. 1 , 5 , 6 , 10 , 17 , 36 – 48 . There is little evidence to guide us on what the most effective, cost-effective, and acceptable interventions are to better meet the complex needs of this population.…”

Section: Discussionmentioning

confidence: 99%

“…Around a third of women with rheumatoid arthritis who are taking medication that is contraindicated in pregnancy, such as methotrexate and leflunomide, use ineffective or no contraception 4 , 5 . Women with ARDs are less likely to have children, have fewer children, and have longer intervals between pregnancies than healthy women, which are influenced by maternal choice, being advised to limit family size, altered sexual functioning, differences in fertility, and pregnancy loss 6 – 8 . The impact of rheumatic diseases on physical functioning can also impact on the daily activities associated with parenting 9 .…”

Section: Introductionmentioning

confidence: 99%

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Reaching a consensus on research priorities for supporting women with autoimmune rheumatic diseases during pre-conception, pregnancy and early parenting: A Nominal Group Technique exercise with lay and professional stakeholders

Phillips¹,

Williams²,

Bowen³

et al. 2018

Wellcome Open Res

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Background:Women with autoimmune rheumatic diseases (ARDs) find it difficult to get information and support with family planning, pregnancy, and early parenting. A systematic approach to prioritising research is required to accelerate development and evaluation of interventions to meet the complex needs of this population. Methods:A Nominal Group Technique (NGT) exercise was carried out with lay and professional stakeholders (n=29). Stakeholders were prepared for debate through presentation of available evidence. Stakeholders completed three tasks to develop, individually rank, and reach consensus on research priorities: Task 1 – mapping challenges and services using visual timelines; Task 2 - identifying research topics; Task 3 - individually ranking research topics in priority order. Results of the ranking exercise were fed back to the group for comment. Results:The main themes emerging from Task 1 were the need for provision of information, multi-disciplinary care, and social and peer support. In Task 2, 15 research topics and 58 sub-topics were identified around addressing the challenges and gaps in care identified during Task 1. In Task 3, a consensus was reached on the ten research topics that should be given the highest priority. These were individually ranked, resulting in the following order of priorities (from 1 – highest to 10 – lowest): 1. Shared decision-making early in the care pathway; 2. Pre-conception counseling; 3. Information about medication use during pregnancy/breastfeeding; 4. Personalised care planning; 5. Support for partners/family members; 6. Information about local support/disease specific issues; 7. Shared decision-making across the care pathway; 8. Peer-support; 9. Social inequalities in care, and; 10. Guidance on holistic/alternative therapies. Conclusions:This systematic approach to identification of research priorities from a multi-disciplinary and lay perspective indicated that activities should focus on development and evaluation of interventions that increase patient involvement in clinical decision-making, multi-disciplinary models of care, and timely provision of information.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reaching a consensus on research priorities for supporting women with autoimmune rheumatic diseases during pre-conception, pregnancy and early parenting: A Nominal Group Technique exercise with lay and professional stakeholders

Phillips¹,

Williams²,

Bowen³

et al. 2018

Wellcome Open Res

View full text Add to dashboard Cite

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Exploring the understanding and experience of women with rheumatic diseases regarding fertility intention- a qualitative content analysis

Manouchehri,

Larki,

Sahebari

2024

BMC Women's Health

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Background Patients with rheumatic diseases (RDs) have a lower desire to have children, fewer children, and a longer interval between their pregnancies, which can be due to the patient’s personal choice, the physician’s advice, changes in sexual activity, changes in fertility, and pregnancy failure. This study aimed to explore the understanding and experience of women with RDs regarding pregnancy intention. Method In Mashhad, Northeast Iran, between December 2022 and March 2023, this qualitative inquiry was carried out. Purposive sampling was used to select thirty women with RDs. Semi-structured interviews were used to collect the data. Graneheim and Lundman’s conventional content analysis method was used to analyze the data. The data organization was done using MAXQDA 12 software. Credibility, dependability, confirmability, and transferability have been considered as elements of trustworthiness. Results The participants’ data analysis revealed the following main theme: “duality of desire and fear in childbearing”. Five main categories were identified, including “Individual health concerns following pregnancy”, “motherhood and womanhood perceptions”, “concerns about child harm”, “contradictory beliefs and attitudes of significant family members and clinicians about pregnancy”, and “lack of social support for fertility”. Conclusion In order to improve the outcomes of pregnancy for women with RDs, the medical professionals who manage them must actively and frequently inquire about their intentions to childbearing and offer them individualized guidance on how to be in the best possible health at the time of conception. Rheumatologists, gynecologists, and reproductive health specialists can better address the sexual and reproductive health needs of this population by enhancing their collaboration in the care of women with RDs.

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Fertility, pregnancy planning, and pharmacotherapy during the pregnancy, postpartum and breastfeeding period in patients with rheumatoid arthritis and other inflammatory arthropathies

Cited by 2 publications

References 40 publications

Reaching a consensus on research priorities for supporting women with autoimmune rheumatic diseases during pre-conception, pregnancy and early parenting: A Nominal Group Technique exercise with lay and professional stakeholders

Reaching a consensus on research priorities for supporting women with autoimmune rheumatic diseases during pre-conception, pregnancy and early parenting: A Nominal Group Technique exercise with lay and professional stakeholders

Exploring the understanding and experience of women with rheumatic diseases regarding fertility intention- a qualitative content analysis

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