Just do it! The pregnancy outcome of a pregnant woman with rheumatoid arthritis will be the same as that of the general population.

A new study has found that pregnancy outcomes in women with rheumatoid arthritis (RA) who adhere to the ideal clinical approach are similar to those in the general population.Dr. Carlo Alber of Ferrara University in Kona, Italy, and colleagues have found that poor compliance in patients with rheumatoid arthritis has poor pregnancy outcomes. Studies have shown that ideal clinical treatment should be followed as far as possible, so that women with rheumatoid arthritis can have the best chance of pregnancy."Dr. scire and his team point out that more and more women with rheumatoid arthritis are reaching remission and starting family life, but almost half of women experience flares during pregnancy.therefore, it is particularly important to use risk stratification management tools and develop specific management plans to improve pregnancy outcomes in patients with rheumatoid arthritis."pre pregnancy counseling should include assessment of disease activity, changes in treatment, and routine obstetric risk factors."Dr. scire and his team have developed a set of seven health care quality system indicators (hcqi) for pregnant women with rheumatoid arthritis, which are developed in part based on the guidance or management of other rheumatic diseases.the indicators were divided into three parts: diagnosis (blood laboratory test, musculoskeletal imaging, antiphospholipid antibody test, antinuclear antibody test or anti ENA test), treatment (no methotrexate / leflunomide exposure, no biological disease modified anti rheumatic drug exposure) and pre partum follow-up (at least one rheumatic follow-up).main results the hcqi stratified tool was used in 443 women with rheumatoid arthritis in their first pregnancy, including 141 women who followed the clinical pathway. The control group consisted of 6097 normal people.there were 157 cases of rheumatoid arthritis pregnant women and 1809 cases of pregnant women with adverse pregnancy outcomes in the experimental group and the control group, 115 cases and 1360 cases of abortion and perinatal death, respectively.the patients with the best compliance were less likely not to receive treatment (39.7% vs 65.9%), and were more likely to receive glucocorticoids (40.4% vs 20.2%) or hydroxychloroquine (41.1% vs 14.6%).patients with good compliance were associated with a 40% reduction in the risk of adverse pregnancy outcomes and a 60% reduction in the risk of miscarriage and perinatal death.patients with good compliance had similar risk of adverse outcomes (or = 0.92) and similar risk of miscarriage or perinatal death (or = 0.77).the researchers believe that the ideal treatment approach is significantly correlated with the research results, which shows that women who do not comply with poor compliance do not receive appropriate treatment of rheumatoid arthritis. The treatment of rheumatoid arthritis should be strengthened before and during pregnancy, because the use of drugs will not only affect the disease itself of pregnant women, but also affect the pregnancy outcome.References: ideal clinical pathway improvements pregnancy outcomes in ra - Medscape - Jan 17, 2020