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Adverse pregnancy outcomes risk factors in spondyloarthritis 1⃣Most common - GSA 2⃣IBD symptoms, aggressive/active disease ⬆️risk 3⃣No difference in age or steroid use Healthy mom, healthy baby. @RheumNow #ACR20 Abs#1324

Robert B Chao, MD doctorRBC ( View Tweet)

Pregnancy outcomes in women with AxSpA 4 prospective cohorts in Europe 328 total pregnancies Favorable outcomes overall 1⃣3% pre-eclampsia 2⃣6-9% gestational DM 3⃣0-5% preterm birth rates (similar to WHO rate 9% in Eur) @RheumNow #ACR20 Abs#1498

Robert B Chao, MD doctorRBC ( View Tweet)

#sjogren #syndrome poster session #ACR20 @RheumNow Clinical characteristics: lung, pregnancy,smoking, cervical lesions, anti La, childhood. https://t.co/QN4FVvQrYN
Sole RetamozoSole ( View Tweet)
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FDA Warning on NSAIDs in Pregnancy

d FDA

The U.S. Food and Drug Administration announced today in a Drug Safety Communication that it is requiring labeling changes for nonsteroidal anti-inflammatory drugs (NSAIDs).

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How pregnancy impacts nr-axSpA disease activity can vary from one woman to another, according to Eric Ruderman, MD, “I’ve had some patients who are better during pregnancy, and some who aren’t,” says Dr. Ruderman. Learn more about pregnancy and nr-axSpA: https://t.co/mC6YcG5lIx

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NM Rheumatology NM_Rheumatology ( View Tweet)

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RheumNow Podcast – Lupus Delights (9.18.20)

d Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow.com:

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COVID-19 Risks in Pregnant Women

d Jack Cush, MD

There has been little science or evidence regarding the effects of COVID-19 infection on pregnancy and vice versa; and now the recent MMWR addresses the subject with two new reports

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RheumNow Podcast - ACR Reproductive Health Slides (9-11-20) Dr Jack Cush reviews the 2020 ACR Reproductive Health Guidelines This past week we presented an overview to the new 2020 ACR ACR 2020 Reproductive Guidelines - Contraception & Counseling https://t.co/vnPh2EQZ0a https://t.co/T4y69DYIH7

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Dr. John Cush RheumNow ( View Tweet)
Candian study of 376 pregnancies (284 F) with #SLE and drug use: only 24.2% on antimalarials, 8.2% azathioprine, 19.7% steroids & 4.8% on NSAIDs during pregnancy. 1st trimester discontinuations seen in 16.7% of HCQ & 29.2% AZA https://t.co/a1SMwZuSlm

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Dr. John Cush RheumNow ( View Tweet)

Swedish registry comparison of 541 PsA 40944 non-PsA pregnancies between 1997-2014, shows PsA pregnancies had increased risks for preterm birth (adj OR 1.63) and caesarean deliveries (OR 1.47), but no increased risks for pre-eclampsia, stillbirth https://t.co/3Udpjhn1pe

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Dr. John Cush RheumNow ( View Tweet)

Discontinuing TNFi before wk 20 is feasible in RA and JIA pregnancy with well- controlled Dz. OTIS study of 490 women compared 25% who D/C TNFi before wk 20 vs 41% taking TNFi after wk 20. D/C TNF not assoc w/ clinical worsening in the 3rd trimester. https://t.co/DtHvQ2rbWY

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Dr. John Cush RheumNow ( View Tweet)

New data on tocilizumab in pregnancy, upshot is: "Tocilizumab concentrations in cord blood and infant serum were 80–90% of those in maternal serum" https://t.co/SEmyTnL7dy

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast - ACR Reproductive Health Slides (9-11-20)

d Jack Cush, MD

Dr. Jack Cush reviews the 2020 ACR Reproductive Health Guidelines presented all week here on RheumNow. 

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Immunomonitoring with microarrays from the SLE PROMISE pregnancy study shows that adverse outcomes (preeclampsia) can be identified by quantifying plasma cell, interferon and neutrophil RNA levels during the pregnancy https://t.co/oLOwkiGhQ2.

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Dr. John Cush RheumNow ( View Tweet)

117 pregnancies exposed to biologics were compared to 585 pregnancies not exposed to biologics; 6% of newborns had ≥1 congenital anomalies. No significant association between biologic exposure and congenital anomalies (HR 1.06; 95%CI 0.46-2.47) was seen. https://t.co/gsKHGiFPOS

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Dr. John Cush RheumNow ( View Tweet)

Systematic review of Paternal DMARD exposure prior to pregnancy shows no firm evidence of harm with TNFi, ABA, RTX, azathioprine, cyclosporine, HCQ, leflunomide, MTX or mycophenolate mofetil. Data from 84 papers, 611 male exposures, 5986 pregnancies https://t.co/VgEsrXhfdh

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Dr. John Cush RheumNow ( View Tweet)

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ACR 2020 Reproductive Guidelines - Lactation Guidance

d Jack Cush, MD

In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.

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The PARA study shows among 249 pregnancies (2002-08), breastfeading was less in RA - at 4-6, 12 & 26 wks postpartum 43%, 26% and 9% of the RA breastfed (vs 63%, 46% &; 41% in controls). Many patients D/C breastfeeding so they could start medication. https://t.co/2205YnoHsb https://t.co/mMyLgMNFfM

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Dr. John Cush RheumNow ( View Tweet)
Small study of 25 pregnancies in RA compared those who continued biologics till conception vs those who stopped before conception. Continuing biologics till conception lead to a significantly shorter time to pregnancy. https://t.co/x9EptzkvYr

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Dr. John Cush RheumNow ( View Tweet)

Dr Uma Mahadevan and colleagues have published guidelines for managing pregnancy in IBD patients. Rec coordinated care w/ maternal-fetal medicine subspecialist, GI doc, preconception planning, more on treatement https://t.co/oAFcGlOU2y

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Dr. John Cush RheumNow ( View Tweet)

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