Fécondité et fertilité dans la polyarthrite rhumatoïde

Abstract

Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatic disease in women of childbearing age. The fertility of these young women can be impacted by the consequences of the disease (fatigue, pain, disability) but also by disease activity and the treatments. Indeed, RA patients have a longer time to conceive than the general population and although pregnancy has traditionally been reported as a “honeymoon” period in rheumatoid arthritis, recent data show that the number of patients improved during pregnancy is not so important. Pregnancy in rheumatoid arthritis is at risk of complications. It must be programmed to best adapt treatment strategies for both the pre-conception period and pregnancy, while keeping the goal of remission of the disease in mind. Pre-conception consultation can be scheduled as soon as the desire of pregnancy is raised by patients, and the desire for pregnancy should be addressed routinely in all patients with rheumatoid arthritis of childbearing age. Management during the preconception period and throughout pregnancy should be multidisciplinary, in close collaboration with gynecological-obstetrical teams.