Abstract
BackgroundRheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are disorders that commonly impact reproductive aged women.FindingsBoth women with RA and SLE have smaller sized families than do controls. In the case of RA factors other than fertility contribute, while in women with SLE there may be diminished ovarian reserve due to cyclophosphamide therapy and advanced maternal age. RA pregnancies can be complicated by preterm birth and small-for-gestational aged infants. SLE pregnancies have higher rates of fetal loss, in particular in those patients with co-existing antiphospholipid syndrome. SLE pregnancies are also more likely to be complicated by pre-eclampsia and hypertension and to result in preterm birth and small-for-gestational aged infants.ConclusionAppropriate fertility evaluation and careful pregnancy planning with coordinated obstetrical care help ensure better outcomes in these patient populations.
Highlights
Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are disorders that commonly impact reproductive aged women
Appropriate fertility evaluation and careful pregnancy planning with coordinated obstetrical care help ensure better outcomes in these patient populations
This article will review the impact of these two common rheumatologic disorders on fertility and pregnancy outcome
Summary
Rheumatoid arthritis and systemic lupus erythematosus are disorders that affect women during the childbearing years Both disorders may impact ultimate family size for multiple reasons; ovarian function is preserved in RA patients, while medication use and severe disease activity or damage may impair fertility in SLE patients. Both RA and SLE pregnancies are associated with higher rates of preterm delivery, C/S rate and SGA infants rates are higher in SLE women. Authors’ contributions BB and AS both completed the literature review and jointly wrote this manuscript Both authors read and approved the final manuscript. Author details 1Division of Rheumatology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. 2Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
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