ABSTRACT
Rheumatic diseases and associated autoimmune phenomena occur frequently in women of childbearing age. Management decisions should consider both the effects of pregnancy on maternal disease and the effects of the disease on the developing fetus. The risk of developing RA was about 30% of expected incidence during the pregnancy period, but was about fivefold greater during the first 3 months postpartum. Disease course tends to be less progressive in women than men, fertility is adversely affected. Strategies for managing certain of these patients are controversial. Although all pregnancies in women with diffuse connective tissue disorders, e.g., systemic lupus erythematosus or systemic sclerosis, should be considered high risk, little effect from pregnancy may occur in such patients with remitted, mild disease. Ethical considerations mandate that most of the information that is used to assess the relative risk of maternal use of a drug on the viability of a pregnancy, fetus is based on developmental toxicity, reproductive studies done in animal models.
