Aktuelles zu Schwangerschaften bei entzündlich-rheumatischen Erkrankungen

Abstract

Women with rheumatic diseases should receive pre-pregnancy counselling to plan their pregnancy based on their individual risk profile. Low-dose aspirin is highly valued in the prevention of pre-eclampsia and is recommended for any lupus patient. In women with rheumatoid arthritis treated with bDMARDs, continuation during pregnancy should be considered to reduce the risk of disease relapse and adverse pregnancy outcomes. NSAIDs should be discontinued after the 20th week of pregnancy if possible. In SLE pregnancies, a lower glucocorticoid dose (6.5-10 mg/day) than previously thought is associated with preterm birth. HCQ therapy in pregnancy offers a benefit that clearly goes beyond mere disease control and should be emphasized accordingly in counselling. The use of HCQ is recommended for all SS-A-positive women from the 10th week of pregnancy at the latest, especially in the case of previous cAVB. Continuation of belimumab during pregnancy should be decided on an individual basis.Stable disease under pregnancy-compatible medication is one of the most important predictive factors for a good pregnancy outcome. Current recommendations should be considered in individual counselling.