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Immunology of pregnancy and reproductive health in autoimmune rheumatic diseases. Update from the 11th International Conference on Reproduction, Pregnancy and Rheumatic Diseases.
Andreoli, Laura; Chighizola, Cecilia B; Iaccarino, Luca; Botta, Angela; Gerosa, Maria; Ramoni, Véronique; Tani, Chiara; Bermas, Bonnie; Brucato, Antonio; Buyon, Jill; Cetin, Irene; Chambers, Christina D; Clowse, Megan E B; Costedoat-Chalumeau, Nathalie; Cutolo, Maurizio; De Carolis, Sara; Dolhain, Radboud; Fazzi, Elisa M; Förger, Frauke; Giles, Ian; Haase, Isabell; Khamashta, Munther; Levy, Roger A; Meroni, Pier Luigi; Mosca, Marta; Nelson-Piercy, Catherine; Raio, Luigi; Salmon, Jane; Villiger, Peter; Wahren-Herlenius, Marie; Wallenius, Marianne; Zanardini, Cristina; Shoenfeld, Yehuda; Tincani, Angela.
  • Andreoli L; Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  • Chighizola CB; Paediatric Rheumatology Unit, ASST G. Pini & CTO, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
  • Iaccarino L; Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
  • Botta A; Department of Obstetrics, Gynaecology and Pediatrics, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
  • Gerosa M; Division of Clinical Rheumatology, ASST Gaetano Pini-CTO, Research Center for Adult and Pediatric Rheumatic Diseases, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
  • Ramoni V; Medicina Generale Lodi, ASST Lodi-Ospedale Maggiore, Lodi, Italy.
  • Tani C; Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Bermas B; UT Southwestern Medical Center, Dallas, TX, USA.
  • Brucato A; Internal Medicine, Fatebenefratelli Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
  • Buyon J; Division of Rheumatology, New York University Grossman School of Medicine, New York, NY, USA.
  • Cetin I; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Department of Woman, Mother and Child, Luigi Sacco and Vittore Buzzi Children Hospitals, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Chambers CD; Department of Pediatrics, University of California, Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, La Jolla, CA, USA.
  • Clowse MEB; Division of Rheumatology & Immunology, Duke University School of Medicine, Durham, NC, USA.
  • Costedoat-Chalumeau N; Internal Medicine Department, Cochin Hospital, Referral center for rare autoimmune and systemic diseases, Université de Paris, CRESS, INSERM, INRA, Paris, France.
  • Cutolo M; Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal M edicine, University of Genoa, IRCSS San Martino Polyclinic, Genoa, Italy.
  • De Carolis S; Department of Obstetrics, Gynaecology and Pediatrics, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
  • Dolhain R; Department of Rheumatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Fazzi EM; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Child Neurology and Psychiatry Unit, ASST Spedali Civili, Brescia, Italy.
  • Förger F; Department of Rheumatology and Immunology, University Hospital (Inselspitaland University of Bern, Bern, Switzerland.
  • Giles I; Centre for Rheumatology, Department of Inflammation, Division of Medicine, University College London, Department of rheumatology, University College London Hospital, London, UK.
  • Haase I; Department for Rheumatology and Hiller Research Institute, Heinrich-Heine-University, Düsseldorf, Germany.
  • Khamashta M; Women & Children's Health, King's College, London, UK; GlaxoSmithKline Global Medical Expert, Dubai, United Arab Emirates.
  • Levy RA; Universidade do Estado de Rio de Janeiro, Rio de Janeiro, Brazil; GlaxoSmithKline Global Medical Expert, Collegeville, PA, USA.
  • Meroni PL; IRCCS Istituto Auxologico Italiano, Immunorheumatology Research Laboratory, Milan, Italy.
  • Mosca M; Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana and Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Nelson-Piercy C; Department of Obstetrics and Gynaecology, Guy's and St Thomas' Hospital, London, UK.
  • Raio L; Department of Obstetrics and Gynaecology, University Hospital (Inselspitaland University of Bern, Bern, Switzerland.
  • Salmon J; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery and Weill Cornell Medicine, New York, NY, USA.
  • Villiger P; Rheumatology and Clinical Immunology, Medical Center Monbijou, Bern, Switzerland.
  • Wahren-Herlenius M; Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
  • Wallenius M; National Advisory Unit on Pregnancy and Rheumatic Diseases, St Olavs Hospital, Trondheim, University Hospital and Institute of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
  • Zanardini C; Department of Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy.
  • Shoenfeld Y; Sackler Faculty of Medicine, Ariel University, Ariel, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
  • Tincani A; Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Electronic address: angela.tincani@unibs.it.
Autoimmun Rev ; 22(3): 103259, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2291252
ABSTRACT
Autoimmune rheumatic diseases (ARD) can affect women and men during fertile age, therefore reproductive health is a priority issue in rheumatology. Many topics need to be considered during preconception counselling fertility, the impact of disease-related factors on pregnancy outcomes, the influence of pregnancy on disease activity, the compatibility of medications with pregnancy and breastfeeding. Risk stratification and individualized treatment approach elaborated by a multidisciplinary team minimize the risk of adverse pregnancy outcomes (APO). Research has been focused on identifying biomarkers that can be predictive of APO. Specifically, preeclampsia and hypertensive disorders of pregnancy tend to develop more frequently in women with ARD. Placental insufficiency can lead to intrauterine growth restriction and small-for-gestational age newborns. Such APO have been shown to be associated with maternal disease activity in different ARD. Therefore, a key message to be addressed to the woman wishing for a pregnancy and to her family is that treatment with compatible drugs is the best way to ensure maternal and fetal wellbeing. An increasing number of medications have entered the management of ARD, but data about their use in pregnancy and lactation are scarce. More information is needed for most biologic drugs and their biosimilars, and for the so-called small molecules, while there is sufficient evidence to recommend the use of TNF inhibitors if needed for keeping maternal disease under control. Other issues related to the reproductive journey have emerged as "unmet needs", such as sexual dysfunction, contraception, medically assisted reproduction techniques, long-term outcome of children, and they will be addressed in this review paper. Collaborative research has been instrumental to reach current knowledge and the future will bring novel insights thanks to pregnancy registries and prospective studies that have been established in several Countries and to their joint efforts in merging data.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / Rheumatic Diseases / Biosimilar Pharmaceuticals Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Child / Female / Humans / Male / Infant, Newborn / Pregnancy Language: English Journal: Autoimmun Rev Journal subject: Allergy and Immunology Year: 2023 Document Type: Article Affiliation country: J.autrev.2022.103259

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autoimmune Diseases / Rheumatic Diseases / Biosimilar Pharmaceuticals Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Child / Female / Humans / Male / Infant, Newborn / Pregnancy Language: English Journal: Autoimmun Rev Journal subject: Allergy and Immunology Year: 2023 Document Type: Article Affiliation country: J.autrev.2022.103259