Aktuelles zu Schwangerschaften bei entzündlich-rheumatischen Erkrankungen

Entzündlich-rheumatische Erkrankungen betreffen häufig Frauen im gebärfähigen Alter. Fragen der Familienplanung sind daher ein wichtiger Bestandteil in der Betreuung von Patientinnen mit entzündlich-rheumatischen Erkrankungen. Eine sorgfältige Planung führt nachweislich zu mehr erfolgreichen und komplikationsarmen Schwangerschaften. Empfehlungen zur Planung von Schwangerschaften sowie zur Therapie vor, in und nach der Schwangerschaft lesen Sie nachfolgend.

Publication History

Article published online:
09 July 2024

• Literatur

• 1 Merz WM, Fischer-Betz R, Hellwig K. et al. Pregnancy and Autoimmune Disease. Dtsch Arztebl Int 2022; 119 (09) 145-156 DOI: 10.3238/arztebl.m2021.0353. (PMID: 34874264)
• 2 Sammaritano LR, Bermas BL, Chakravarty EE. et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis & Rheumatology (Hoboken, NJ) 2020; 72 (04) 529-556 DOI: 10.1002/art.41191.
• 3 No authors listed. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstetrics and gynecology 2020; 135 (06) e237-e260 DOI: 10.1097/AOG.0000000000003891.
• 4 Gerardi MC, Crisafulli F, García-Fernandez A. et al. Stopping bDMARDs at the beginning of pregnancy is associated with disease flares and preterm delivery in women with rheumatoid arthritis. Front Pharmacol 2022; 13: 887462 DOI: 10.3389/fphar.2022.887462).
• 5 Smeele H, Röder E, Mulders A. et al. Tumour necrosis factor inhibitor use during pregnancy is associated with increased birth weight of rheumatoid arthritis patients' offspring. Ann Rheum Dis 2022; 81 (10) 1367-1373 DOI: 10.1136/ard-2022-222679.
• 6 U.S. Food and Drug Administration. FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid. Accessed November 09, 2022 at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-avoiding-use-nsaids-pregnancy-20-weeks-or-later-because-they-can-result-low-amniotic
• 7 Nathan NO, Mørch LS, Wu CS. et al. Rheumatoid arthritis and risk of spontaneous abortion: a Danish nationwide cohort study. Rheumatology (Oxford, England) 2020; 59 (08) 1984-1991 DOI: 10.1093/rheumatology/kez565. (PMID: 31776579)
• 8 Keeling SO, Bowker SL, Savu A. et al. A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes. The Journal of Rheumatology 2020; 47 (02) 197-203 DOI: 10.3899/jrheum.181320. (PMID: 31043549)
• 9 Mehta B, Luo Y, Xu J. et al. Trends in Maternal and Fetal Outcomes Among Pregnant Women With Systemic Lupus Erythematosus in the United States: A Cross-sectional Analysis. Annals of internal medicine 2019; 171 (03) 164-171 DOI: 10.7326/M19-0120.
• 10 He WR, Wei H. Maternal and fetal complications associated with systemic lupus erythematosus: An updated meta-analysis of the most recent studies (2017–2019). Medicine 2020; 99 (16) e19797 DOI: 10.1097/MD.0000000000019797. (PMID: 32311994)
• 11 Tani C, Zucchi D, Haase I. et al. Are remission and low disease activity state ideal targets for pregnancy planning in Systemic Lupus Erythematosus? A multicentre study. Rheumatology (Oxford) 2021; 60 (12) 5610-5619 DOI: 10.1093/rheumatology/keab155. (PMID: 33590843)
• 12 Palmsten K, Bandoli G, Watkins J. et al. Oral corticosteroids and risk of preterm birth in the California Medicaid. J Allergy Clin Immunol Pract 2021; 9: 375-384 DOI: 10.1016/j.jaip.2020.07.047. (PMID: 32791247)
• 13 Shimada H, Wakiya R, Kanenishi K. et al. Preterm birth is strongly affected by the glucocorticoid dose during pregnancy in women complicated by systemic lupus erythematosus. Arthritis Res Ther 2022; 24 (01) 10 DOI: 10.1186/s13075-021-02699-1. (PMID: 34980235)
• 14 Simard JF, Rossides M, Arkema EV. et al. Maternal Hypertensive Disorders in Pregnant Women With Systemic Lupus Erythematosus and Future Cardiovascular Outcomes. Arthritis care & research 2021; 73 (04) 574-579 DOI: 10.1002/acr.24160.
• 15 Saavedra MÁ, Miranda-Hernández D, Lara-Mejía A. et al. Use of antimalarial drugs is associated with a lower risk of preeclampsia in lupus pregnancy: A prospective cohort study. International journal of rheumatic diseases 2020; 23 (05) 633-640 DOI: 10.1111/1756-185X.13830.
• 16 Petri M, Landy H, Clowse M. et al. Belimumab use during pregnancy: a summary of birth defects and pregnancy loss from belimumab clinical trials, a pregnancy registry and postmarketing reports. Ann Rheum Dis 2022; 2022-2225 DOI: 10.1136/ard-2022-222505.
• 17 Russell MD, Dey M, Flint J. et al. British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford) 2022; keac551 DOI: 10.1093/rheumatology/keac551. (PMID: 36318966)
• 18 Izmirly P, Kim M, Friedman DM. et al. Hydroxychloroquine to Prevent Recurrent Congenital Heart Block in Fetuses of Anti-SSA/Ro-Positive Mothers. Journal of the American College of Cardiology 2020; 76 (03) 292-302 DOI: 10.1016/j.jacc.2020.05.045. (PMID: 32674792)
• 19 Friedman DM, Kim M, Costedoat-Chalumeau N. et al. Electrocardiographic QT Intervals in Infants Exposed to Hydroxychloroquine Throughout Gestation. Circulation. Arrhythmia and electrophysiology 2020; 13 (10) e008686 DOI: 10.1161/CIRCEP.120.008686.
• 20 Blaschke K, Fischer-Betz R, Marschall U. et al. Treatment Patterns and Resource Utilization of Pregnant Women with Inflammatory Rheumatic Diseases or Psoriasis in Germany: A Claims Database Analysis. Rheumatol Ther 2021; 8 (04) 1565-1584 DOI: 10.1007/s40744-021-00347-3.