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MotherToBaby

Medications and More during pregnancy and breastfeeding

Rheumatoid Arthritis

Selected References:

  • Aljary H et al. 2020. Pregnancy outcomes in women with rheumatoid arthritis:  a retrospective population-based cohort study. The Journal of Maternal-Fetal & Neonatal Medicine; 33;4:618-624. 
  • Atladóttir HO, et al. 2009. Association of family history of autoimmune diseases and autism spectrum disorders. Pediatr; 124:687-694. 
  • Bandoli G et al. 2020. Mediation of adverse pregnancy outcomes in autoimmune conditions by pregnancy complications. Arthritis Care Res; 72(2):256-264. 
  • Bermas BL, Sammaritano LR. 2015. Fertility and pregnancy in rheumatoid arthritis and systemic lupus erythematosus. Fertil Res Pract; 27;1:13. 
  • Bourg M et al. 2020. Fertility and sexuality of women with inflammatory arthritis. European Journal of Obstetrics & Gynecology and Reproductive Biology; 251:199-205. 
  • Brouwer J, et al. 2013. Levels of serum anti-Müllerian hormone, a marker for ovarian reserve, in women with rheumatoid arthritis. Arthritis Care Res (Hoboken); 65(9):1534-8. 
  • Brouwer J, et al. 2015. Brief report: Miscarriages in female rheumatoid arthritis patients: Associations with serologic findings, disease activity, and antirheumatic drug treatment. Arthritis Rheumatol; 67(7):1738-1743.  
  • Brouwer J, et al. 2015. Fertility in women with rheumatoid arthritis: influence of disease activity and medication. Ann Rheum Dis; 74(10):1836-1841.  
  • Brouwer J, et al. 2017.Subfertility in Women With Rheumatoid Arthritis and the Outcome of Fertility Assessments. Arthritis Care Res (Hoboken); 69(8):1142-1149. 
  • Chang T, et al. 2024. Rheumatoid arthritis and adverse pregnancy outcomes: a bidirectional two-sample mendelian randomization study. BMC Pregnancy Childbirth; 24(1):517.  
  • Comi AM, et al. 1999. Familial clustering of autoimmune disorders and evaluation of medical risk factors in autism. J Child Neurol; 14:388-394 
  • de Man YA, et al. 2014. Disease activity or remission of rheumatoid arthritis before, during and following pregnancy. Curr Opin Rheumatol; 26(3):329-333. 
  • de Man YA, et al. 2008. Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study. Arthritis Rheumatol, 59(9):1241-1248. 
  • De Santis M, et al. 2005. Paternal and maternal exposure to leflunomide: pregnancy and neonatal outcome. Ann Rheum Dis; 64(7):1096-1097. 
  • Dissanayke TD et al. 2020. Peripartum issues in the inflammatory arthritis patient: a survey of the RAPPORT registry. Nature Scientific Report, 10:3733. 
  • Ekström K, et al. 2003. Risk of malignant lymphomas in patients with rheumatoid arthritis and in their first-degree relatives. Arthritis Rheum; 48:963-970. 
  • Emadi SA, et al. 2025. Impact of Rheumatoid Arthritis on Pregnancy Outcomes: Increased Risks of Abortion and Low Birth Weight in a Prospective Case-Control Study. Mediterr J Rheumatol; 36(4):557-565.  
  • Fischer-Betz R, et al. 2015.  High risk of flares during pregnancy in women with rheumatoid arthritis who discontinue treatment with TNF Inhibitors at conception. Arthritis Rheumatol; 67(suppl 10).  
  • Förger F, et al. 2012. Pregnancy mediated improvement of rheumatoid arthritis. Swiss Med Wkly; 142:w13644.  
  • Förger F et al. 2019. Discontinuing TNF-inhibitors before gestational week 20 in well controlled rheumatoid arthritis and juvenile arthritis is not associated with a disease worsening in late pregnancy. Arthritis and Rheumatology;  71(6)901-907. 
  • Giannakaki AG, et al. 2025. Current Approaches to the Management of Rheumatic Diseases in Pregnancy: Risk Stratification, Therapeutic Advances, and Maternal-Fetal Outcomes. J Pers Med; 15(9):406. 
  • Götestam Skorpen C, 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. 
  • Hellgren K, et al. 2022. Pregnancy outcomes in relation to disease activity and anti-rheumatic treatment strategies in women with rheumatoid arthritis: a matched cohort study from Sweden and Denmark. Rheumatology (Oxford); 61(9):3711-3722.  
  • Huang W, et al. 2023. Maternal and fetal outcomes in pregnant women with rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol; 42(3):855-870. 
  • Ikram N, et al. Breastfeeding in women with rheumatic diseases. Lupus Sci Med; Apr;8(1):e000491.  
  • Jethwa H, et al. 2019. Does Rheumatoid Arthritis Really Improve During Pregnancy? A Systematic Review and Metaanalysis. J Rheumatol; 46(3):245-250.  
  • Katz PP. 2006. Childbearing decisions and family size among women with rheumatoid arthritis. Arthritis Rheum; 55(2):217-23. 
  • Keeling SO, et al. 2020. A population-level analysis of the differing effects of rheumatoid arthritis and spondyloarthritis on peripartum outcomes. J Rheumatol; 47:197-203. 
  • Krause ML, Makol A. 2016. Management of rheumatoid arthritis during pregnancy: challenges and solutions. Open Access Rheumatol; 8:23-36.  
  • Littlejohn, Emily A. 2020. Pregnancy and rheumatoid arthritis. Best Practice & Research Clinical Obstetrics and Gynaecology; 64: 52-58 
  • Liu S,et at. 2025. Best Evidence Summary for Preconception Management in Childbearing-Age Patients with Rheumatoid Arthritis. J Multidiscip Healthc; 18:8197-8208.  
  • Lv J, et al. 2023. Association between disease activity of rheumatoid arthritis and maternal and fetal outcomes in pregnant women: a systematic review and meta-analysis. BMC Pregnancy Childbirth; 23(1):724.  
  • Mahadevan U, et al. 2014. 960 Exposure to anti-TNFα therapy in the third trimester of pregnancy is not associated with increased adverse outcomes: Results from the PIANO Registry. Gastroenterol; 146(5), Suppl 1:S-170. 
  • Mellemkjær L, et al. 2000. Cancer among children of parents with autoimmune diseases. Br J Cancer; 82:1353-1357. 
  • Mishra N, et al. 2026. The Interplay Between Rheumatoid Arthritis and Pregnancy Outcomes: A Narrative Review. Cureus; 18(3):e105178. 
  • Nathan NO, et al. 2020. Rheumatoid arthritis and risk of spontaneous abortion: a Danish nationwide cohort study. Rheumatology; 59:1984-1991. 
  • Østensen M, et al. 2015. State of the art: Reproduction and pregnancy in rheumatic diseases. Autoimmun Rev; 14(5):376-86.  
  • Park JS et al. 2022. Risk of pregnancy complications and low birth weight offsprings in Korean women with rheumatic diseases: a nationwide population-based study. J Korean Med Sci; 37(2):e18 
  • Quaak CH, et al. 2026. Time to pregnancy in women with rheumatoid arthritis who want to conceive treated according to a treat-to-target approach: a comparison of an observational cohort with a historical reference cohort. Lancet Rheumatol; 8(6):e461-e469. 
  • Ranjbaran ME, Kazemi M. 2024. Reproductive health and rheumatoid arthritis. BMC Rheumatol; 8(1):53.  
  • Rom AL, et al. 2014. Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis: a nationwide cohort study. Arthritis Rheumatol; 66(12):3265-73. 
  • Rom AL, et al. 2016. Parental rheumatoid arthritis and long-term child morbidity: a nationwide cohort study. Ann Rheum Dis; 75:1831-1837 
  • Sagberg I, et al. 2026. The biologic era and pregnancy in rheumatoid arthritis: a prospective multicenter study from the Norwegian RevNatus registry. BMC Rheumatol; doi: 10.1186/s41927-026-00663-7. Epub ahead of print. 
  • Sammaritano LR, et al. 2020. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis & Rheumatology; 72(4): 529-556. 
  • Sims C, Talabi MB. 2025. Family Planning and Rheumatoid Arthritis. Curr Rheumatol Rep;27(1):26.  
  • Spinillo A, et al. 2016. The impact of unrecognized autoimmune rheumatic diseases on the incidence of preeclampsia and fetal growth restriction: a longitudinal cohort study. BMC Pregnancy Childbirth; 16(1):313. 
  • Tsai YC, et al. 2022. Fetal-neonatal and maternal pregnancy outcomes in women with rheumatoid arthritis: a population-based cohort study. BMJ Open; 12(10):e059203. 
  • Valdeyron C, et al. 2021. Impact of disease activity and treatments on ovarian reserve in patients with rheumatoid arthritis in the ESPOIR cohort. Rheumatology (Oxford); 60(4):1863-1870. 
  • van den Brandt S, 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. 
  • Viktil KK, et al. 2012. Outcomes after anti-rheumatic drug use before and during pregnancy: A cohort study among 50,000 pregnant women and expectant fathers. Scand J Rheumatol; 41(3):196-201. 
  • Vinet, É and Bernatsky, S. 2017. Outcomes in children born to women with rheumatic diseases. Rheumatic Disease Clinics; 43(2):263-273. 
  • Wallenius M, et al. 2015. Miscarriage and Stillbirth in Women with Rheumatoid Arthritis. J Rheumatol; 42(9):1570-2. 
  • Williams M and Chakravarty EF, 2014. Rheumatoid arthritis and pregnancy: impediments to optimal management of both biologic use before, during and after pregnancy. Curr Opin Rheumatol; 26(3):341-346. 
  • Wojcik S, et al. 2015. Risk of autism spectrum disorders in children born to mothers with rheumatoid arthritis: a systematic literature review. J Rheumatol; 42:1263-1351.  
  • Zhu EH, et al. 2025. Maternal rheumatoid arthritis and the risk of offspring autism spectrum disorder: two national birth cohorts and a meta-analysis. Mol Autism; 16(1):61. 
  • Ziegler CI, et al. 2025. Deciphering the influence of pregnancy on rheumatoid arthritis and psoriatic arthritis: insights from musculoskeletal ultrasound dynamics. Arch Gynecol Obstet; 312(4):1133-1143.  

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