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Erschienen in: rheuma plus 6/2018

03.09.2018 | Schwangerschaft

Update zu rheumatischen Erkrankungen und Familienplanung

verfasst von: I. Haase, R. Fischer-Betz

Erschienen in: rheuma plus | Ausgabe 6/2018

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Zusammenfassung

Schwangerschaften bei Patientinnen mit rheumatischen Erkrankungen stellen eine besondere Herausforderung für den behandelnden Arzt dar. Dies beginnt bei einer kompetenten Beratung der oft besorgten Patientin vor Konzeption und mündet in eine engmaschige Begleitung während und nach der Gravidität. Inzwischen sind immer mehr Risikofaktoren für ungünstige Schwangerschaftsverläufe identifiziert, die teils kontrollierbar oder gar iatrogen bedingt sind und folglich bedacht werden sollten. Ein weiterer Grundstein in der Behandlung dieser Patientengruppe ist die Auswahl von und Aufklärung zu geeigneten Medikamenten während Schwangerschaft und Stillzeit. Hierzu liefern Studien und aktuelle Empfehlungen wertvolle Hilfestellungen. Gelingt eine konsequente Krankheitskontrolle unter schwangerschaftskompatibler Medikation, können betroffene Frauen in vielen Fällen einen erfolgreichen Schwangerschaftsausgang erleben.
Literatur
1.
Zurück zum Zitat Andreoli L, Bertsias GK, Agmon-Levin N et al (2017) EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 76(3):476–485 CrossRef Andreoli L, Bertsias GK, Agmon-Levin N et al (2017) EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 76(3):476–485 CrossRef
2.
Zurück zum Zitat Barsalou J, Jaeggi E, Laskin CA et al (2017) Prenatal exposure to antimalarials decreases the risk of cardiac but not non-cardiac neonatal lupus. Rheumatol (oxford) 56(9):1552–1559 CrossRef Barsalou J, Jaeggi E, Laskin CA et al (2017) Prenatal exposure to antimalarials decreases the risk of cardiac but not non-cardiac neonatal lupus. Rheumatol (oxford) 56(9):1552–1559 CrossRef
3.
Zurück zum Zitat van den Brandt S, Zbinden A, Baeten D et al (2017) Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther 19(1):64 CrossRef van den Brandt S, Zbinden A, Baeten D et al (2017) Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther 19(1):64 CrossRef
4.
Zurück zum Zitat Brito-Zerón P, Izmirly PM, Ramos-Casals M et al (2015) The clinical spectrum of autoimmune congenital heart block. Nat Rev Rheumatol 11(5):301–312 CrossRef Brito-Zerón P, Izmirly PM, Ramos-Casals M et al (2015) The clinical spectrum of autoimmune congenital heart block. Nat Rev Rheumatol 11(5):301–312 CrossRef
5.
Zurück zum Zitat Brouwer J, Hazes JMW, Laven JSE et al (2015) Fertility in women with rheumatoid arthritis. Ann Rheum Dis 74(10):1836–1841 CrossRef Brouwer J, Hazes JMW, Laven JSE et al (2015) Fertility in women with rheumatoid arthritis. Ann Rheum Dis 74(10):1836–1841 CrossRef
6.
Zurück zum Zitat Brouwer J, Fleurbaaij R, Hazes JMW et al (2017) Subfertility in Women With Rheumatoid Arthritis and the Outcome of Fertility Assessments. Arthritis Care Res (hoboken) 69(8):1142–1149 CrossRef Brouwer J, Fleurbaaij R, Hazes JMW et al (2017) Subfertility in Women With Rheumatoid Arthritis and the Outcome of Fertility Assessments. Arthritis Care Res (hoboken) 69(8):1142–1149 CrossRef
7.
Zurück zum Zitat Brucato A, Doria A, Frassi M et al (2002) Pregnancy outcome in 100 women with autoimmune diseases and anti-Ro/SSA antibodies. Lupus 11(11):716–721 CrossRef Brucato A, Doria A, Frassi M et al (2002) Pregnancy outcome in 100 women with autoimmune diseases and anti-Ro/SSA antibodies. Lupus 11(11):716–721 CrossRef
8.
Zurück zum Zitat Bundhun PK, Soogund MZS, Huang F (2017) Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy. J Autoimmun 79:17–27 CrossRef Bundhun PK, Soogund MZS, Huang F (2017) Impact of systemic lupus erythematosus on maternal and fetal outcomes following pregnancy. J Autoimmun 79:17–27 CrossRef
9.
Zurück zum Zitat Buyon J P (2011) Neonatal Lupus. In: Lahita R G (Hrsg) Systemic lupus erythematosus. 5. Aufl, Elsevier Acad Press, Amsterdam, S 541 CrossRef Buyon J P (2011) Neonatal Lupus. In: Lahita R G (Hrsg) Systemic lupus erythematosus. 5. Aufl, Elsevier Acad Press, Amsterdam, S 541 CrossRef
10.
Zurück zum Zitat Buyon JP, Kim MY, Guerra MM et al (2015) Predictors of Pregnancy Outcomes in Patients With Lupus. Ann Intern Med 163(3):153–163 CrossRef Buyon JP, Kim MY, Guerra MM et al (2015) Predictors of Pregnancy Outcomes in Patients With Lupus. Ann Intern Med 163(3):153–163 CrossRef
11.
Zurück zum Zitat Buyon J P, Kim M Y, Guerra M M et  al (2017) Kidney Outcomes and Risk Factors for Nephritis (Flare/De Novo) in a Multiethnic Cohort of Pregnant Patients with Lupus. Clin J Am Soc Nephrol 12(6):940–946 CrossRef Buyon J P, Kim M Y, Guerra M M et  al (2017) Kidney Outcomes and Risk Factors for Nephritis (Flare/De Novo) in a Multiethnic Cohort of Pregnant Patients with Lupus. Clin J Am Soc Nephrol 12(6):940–946 CrossRef
12.
Zurück zum Zitat Cervera R (2008) Lessons from the “Euro-Phospholipid” project. Autoimmun Rev 7(3):174–178 CrossRef Cervera R (2008) Lessons from the “Euro-Phospholipid” project. Autoimmun Rev 7(3):174–178 CrossRef
13.
Zurück zum Zitat Eudy AM, Siega-Riz AM, Engel SM et al (2018) E ffect of pregnancy on disease flares in patients with systemic lupus erythematosus. Ann Rheum Dis 77(6):855–860 PubMed Eudy AM, Siega-Riz AM, Engel SM et al (2018) E ffect of pregnancy on disease flares in patients with systemic lupus erythematosus. Ann Rheum Dis 77(6):855–860 PubMed
14.
Zurück zum Zitat Eudy AM, Jayasundara M, Haroun T et al (2018) Reasons for cesarean and medically indicated deliveries in pregnancies in women with systemic lupus erythematosus. Lupus 27(3):351–356 CrossRef Eudy AM, Jayasundara M, Haroun T et al (2018) Reasons for cesarean and medically indicated deliveries in pregnancies in women with systemic lupus erythematosus. Lupus 27(3):351–356 CrossRef
15.
Zurück zum Zitat Flint J, Panchal S, Hurrell A et al (2016) BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I. Rheumatol (oxford) 55(9):1693–1697 CrossRef Flint J, Panchal S, Hurrell A et al (2016) BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I. Rheumatol (oxford) 55(9):1693–1697 CrossRef
16.
Zurück zum Zitat Götestam Skorpen C, Hoeltzenbein M, Tincani A et al (2016) The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis 75(5):795–810 CrossRef Götestam Skorpen C, Hoeltzenbein M, Tincani A et al (2016) The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis 75(5):795–810 CrossRef
17.
Zurück zum Zitat Götestam Skorpen C, Lydersen S, Gilboe I‑M et al (2017) Disease Activity During Pregnancy and the First Year Postpartum in Women With Systemic Lupus Erythematosus. Arthritis Care Res (hoboken) 69(8):1201–1208 CrossRef Götestam Skorpen C, Lydersen S, Gilboe I‑M et al (2017) Disease Activity During Pregnancy and the First Year Postpartum in Women With Systemic Lupus Erythematosus. Arthritis Care Res (hoboken) 69(8):1201–1208 CrossRef
18.
Zurück zum Zitat Götestam Skorpen C, Lydersen S, Gilboe I‑M et al (2018) Women with systemic lupus erythematosus get pregnant more easily than women with rheumatoid arthritis. Rheumatol (oxford) 57(6):1072–1079 CrossRef Götestam Skorpen C, Lydersen S, Gilboe I‑M et al (2018) Women with systemic lupus erythematosus get pregnant more easily than women with rheumatoid arthritis. Rheumatol (oxford) 57(6):1072–1079 CrossRef
19.
Zurück zum Zitat Ince-Askan H, Hazes JMW, Dolhain RJEM (2016) Is Disease Activity in Rheumatoid Arthritis during Pregnancy and after Delivery Predictive for Disease Activity in a Subsequent Pregnancy? J Rheumatol 43(1):22–25 CrossRef Ince-Askan H, Hazes JMW, Dolhain RJEM (2016) Is Disease Activity in Rheumatoid Arthritis during Pregnancy and after Delivery Predictive for Disease Activity in a Subsequent Pregnancy? J Rheumatol 43(1):22–25 CrossRef
20.
Zurück zum Zitat Ince-Askan H, Hazes JMW, Dolhain RJEM (2017) Identifying Clinical Factors Associated With Low Disease Activity and Remission of Rheumatoid Arthritis During Pregnancy. Arthritis Care Res (hoboken) 69(9):1297–1303 CrossRef Ince-Askan H, Hazes JMW, Dolhain RJEM (2017) Identifying Clinical Factors Associated With Low Disease Activity and Remission of Rheumatoid Arthritis During Pregnancy. Arthritis Care Res (hoboken) 69(9):1297–1303 CrossRef
21.
Zurück zum Zitat Jakobsson GL, Stephansson O, Askling J et al (2016) Pregnancy outcomes in patients with ankylosing spondylitis. Ann Rheum Dis 75(10):1838–1842 CrossRef Jakobsson GL, Stephansson O, Askling J et al (2016) Pregnancy outcomes in patients with ankylosing spondylitis. Ann Rheum Dis 75(10):1838–1842 CrossRef
22.
Zurück zum Zitat Kim MY, Guerra MM, Kaplowitz E et al (2018) Complement activation predicts adverse pregnancy outcome in patients with systemic lupus erythematosus and/or antiphospholipid antibodies. Ann Rheum Dis 77(4):549–555 CrossRef Kim MY, Guerra MM, Kaplowitz E et al (2018) Complement activation predicts adverse pregnancy outcome in patients with systemic lupus erythematosus and/or antiphospholipid antibodies. Ann Rheum Dis 77(4):549–555 CrossRef
23.
Zurück zum Zitat Kwok L‑W, Tam L‑S, Zhu T et al (2011) Predictors of maternal and fetal outcomes in pregnancies of patients with systemic lupus erythematosus. Lupus 20(8):829–836 CrossRef Kwok L‑W, Tam L‑S, Zhu T et al (2011) Predictors of maternal and fetal outcomes in pregnancies of patients with systemic lupus erythematosus. Lupus 20(8):829–836 CrossRef
24.
Zurück zum Zitat Langen ES, Chakravarty EF, Liaquat M et al (2014) High rate of preterm birth in pregnancies complicated by rheumatoid arthritis. Am J Perinatol 31(1):9–14 PubMed Langen ES, Chakravarty EF, Liaquat M et al (2014) High rate of preterm birth in pregnancies complicated by rheumatoid arthritis. Am J Perinatol 31(1):9–14 PubMed
25.
Zurück zum Zitat Levesque K, Morel N, Maltret A et al (2015) Description of 214 cases of autoimmune congenital heart block. Autoimmun Rev 14(12):1154–1160 CrossRef Levesque K, Morel N, Maltret A et al (2015) Description of 214 cases of autoimmune congenital heart block. Autoimmun Rev 14(12):1154–1160 CrossRef
26.
Zurück zum Zitat Lisney AR, Szelinski F, Reiter K et al (2017) High maternal expression of SIGLEC1 on monocytes as a surrogate marker of a type I interferon signature is a risk factor for the development of autoimmune congenital heart block. Ann Rheum Dis 76(8):1476–1480 CrossRef Lisney AR, Szelinski F, Reiter K et al (2017) High maternal expression of SIGLEC1 on monocytes as a surrogate marker of a type I interferon signature is a risk factor for the development of autoimmune congenital heart block. Ann Rheum Dis 76(8):1476–1480 CrossRef
27.
Zurück zum Zitat de Man YA, Dolhain RJEM, van de Geijn FE et al (2008) Disease activity of rheumatoid arthritis during pregnancy. Arthritis Rheum 59(9):1241–1248 CrossRef de Man YA, Dolhain RJEM, van de Geijn FE et al (2008) Disease activity of rheumatoid arthritis during pregnancy. Arthritis Rheum 59(9):1241–1248 CrossRef
28.
Zurück zum Zitat de Man YA, Hazes JMW, van der Heide H et al (2009) Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight. Arthritis Rheum 60(11):3196–3206 CrossRef de Man YA, Hazes JMW, van der Heide H et al (2009) Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight. Arthritis Rheum 60(11):3196–3206 CrossRef
29.
Zurück zum Zitat Mariette X, Förger F, Abraham B et al (2018) Lack of placental transfer of certolizumab pegol during pregnancy. Ann Rheum Dis 77(2):228–233 CrossRef Mariette X, Förger F, Abraham B et al (2018) Lack of placental transfer of certolizumab pegol during pregnancy. Ann Rheum Dis 77(2):228–233 CrossRef
30.
Zurück zum Zitat Martínez-Sánchez N, Pérez-Pinto S, Robles-Marhuenda Á et al (2017) Obstetric and perinatal outcome in anti-Ro/SSA-positive pregnant women. Immunol Res 65(2):487–494 CrossRef Martínez-Sánchez N, Pérez-Pinto S, Robles-Marhuenda Á et al (2017) Obstetric and perinatal outcome in anti-Ro/SSA-positive pregnant women. Immunol Res 65(2):487–494 CrossRef
31.
Zurück zum Zitat Polachek A, Li S, Polachek IS et al (2017) Psoriatic arthritis disease activity during pregnancy and the first-year postpartum. Semin Arthritis Rheum 46(6):740–745 CrossRef Polachek A, Li S, Polachek IS et al (2017) Psoriatic arthritis disease activity during pregnancy and the first-year postpartum. Semin Arthritis Rheum 46(6):740–745 CrossRef
32.
Zurück zum Zitat Rodríguez-Almaraz ME, Herraiz I, Gómez-Arriaga PI et al (2018) The role of angiogenic biomarkers and uterine artery Doppler in pregnant women with systemic lupus erythematosus or antiphospholipid syndrome. Pregnancy Hypertens 11:99–104 CrossRef Rodríguez-Almaraz ME, Herraiz I, Gómez-Arriaga PI et al (2018) The role of angiogenic biomarkers and uterine artery Doppler in pregnant women with systemic lupus erythematosus or antiphospholipid syndrome. Pregnancy Hypertens 11:99–104 CrossRef
33.
Zurück zum Zitat Rom A L, Wu C S, Olsen J et al (2014) Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis. Arthritis & rheumatology (Hoboken, N.J.) 66(12):3265–3273 Rom A L, Wu C S, Olsen J et al (2014) Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis. Arthritis & rheumatology (Hoboken, N.J.) 66(12):3265–3273
34.
Zurück zum Zitat Ruffatti A, Tonello M, Visentin MS et al (2011) Risk factors for pregnancy failure in patients with anti-phospholipid syndrome treated with conventional therapies. Rheumatol (oxford) 50(9):1684–1689 CrossRef Ruffatti A, Tonello M, Visentin MS et al (2011) Risk factors for pregnancy failure in patients with anti-phospholipid syndrome treated with conventional therapies. Rheumatol (oxford) 50(9):1684–1689 CrossRef
35.
Zurück zum Zitat Simard JF, Arkema EV, Nguyen C et al (2017) Early-onset Preeclampsia in Lupus Pregnancy. Paediatr Perinat Epidemiol 31(1):29–36 CrossRef Simard JF, Arkema EV, Nguyen C et al (2017) Early-onset Preeclampsia in Lupus Pregnancy. Paediatr Perinat Epidemiol 31(1):29–36 CrossRef
36.
Zurück zum Zitat Uhler ML, Hsu JW, Fisher SG et al (2001) The effect of nonsteroidal anti-inflammatory drugs on ovulation. Fertil Steril 76(5):957–961 CrossRef Uhler ML, Hsu JW, Fisher SG et al (2001) The effect of nonsteroidal anti-inflammatory drugs on ovulation. Fertil Steril 76(5):957–961 CrossRef
37.
Zurück zum Zitat Ursin K, Lydersen S, Skomsvoll JF et al (2018) Disease activity during and after pregnancy in women with axial spondyloarthritis. Rheumatol (oxford) 57(6):1064–1071 CrossRef Ursin K, Lydersen S, Skomsvoll JF et al (2018) Disease activity during and after pregnancy in women with axial spondyloarthritis. Rheumatol (oxford) 57(6):1064–1071 CrossRef
38.
Zurück zum Zitat Wallenius M, Salvesen KÅ, Daltveit AK et al (2015) Miscarriage and Stillbirth in Women with Rheumatoid Arthritis. J Rheumatol 42(9):1570–1572 CrossRef Wallenius M, Salvesen KÅ, Daltveit AK et al (2015) Miscarriage and Stillbirth in Women with Rheumatoid Arthritis. J Rheumatol 42(9):1570–1572 CrossRef
39.
Zurück zum Zitat Yelnik CM, Laskin CA, Porter TF et al (2016) Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients. Lupus Sci Med 3(1):e131 CrossRef Yelnik CM, Laskin CA, Porter TF et al (2016) Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients. Lupus Sci Med 3(1):e131 CrossRef
Metadaten
Titel
Update zu rheumatischen Erkrankungen und Familienplanung
verfasst von
I. Haase
R. Fischer-Betz
Publikationsdatum
03.09.2018
Verlag
Springer Vienna
Erschienen in
rheuma plus / Ausgabe 6/2018
Print ISSN: 1868-260X
Elektronische ISSN: 2191-2610
DOI
https://doi.org/10.1007/s12688-018-0205-z