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The effect of biological treatment on female fertility: A cohort study of women with rheumatoid arthritis and psoriatic arthritis.

Semin Arthritis Rheum

December 2024

The IVF Unit, Hadassah Medical Center Mount Scopus, Jerusalem, Israel; Department of Obstetrics and Gynecology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Objectives: To investigate female fertility in patients with rheumatoid arthritis (RA) exposed to biological drugs.

Methods: In this retrospective cohort study, based on an electronic health record database, 4517 women with RA were compared to 1415 patients with psoriatic arthritis (PsA). Patients were 18-40 years-of-age at diagnosis.

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Article Synopsis
  • Patients with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) face a significantly higher risk of adverse pregnancy outcomes, including preterm births and low birth weight infants.
  • A study conducted in Denmark from 2008-2018 analyzed 503,491 singleton pregnancies, with 2,206 involving mothers with RA and JIA, looking at fetal growth and risks such as being small for gestational age.
  • Findings indicated that while RA and JIA did not reduce estimated fetal weight, corticosteroid and sulfasalazine use during pregnancy were linked to poorer fetal growth and higher risks of small for gestational age infants.
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Background: Serum human chorionic gonadotropin (HCG) is a glycoprotein hormone secreted by the trophoblast cells of the placenta. HCG levels are helpful in confirming and monitoring pregnancy, as well as in the diagnosis and monitoring of trophoblastic tumors. Therefore, the accuracy of HCG detection results is of great significance for the diagnosis and differential diagnosis of pregnancy and germ cell tumors.

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Article Synopsis
  • Autoimmune connective tissue diseases (CTDs) such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and rheumatoid arthritis (RA) significantly impact pregnant women, leading to maternal and fetal complications.
  • A retrospective study analyzed data from over 18 million deliveries and found higher odds of maternal death, acute kidney injury, and severe complications in mothers with CTDs, alongside increased risks of adverse fetal outcomes like stillbirth and preterm labor.
  • The findings highlight the need for specific preconception counseling and management approaches to improve health outcomes for pregnant women with autoimmune CTDs.
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