Pregnancy

pregnant, pregnancy, mother, fertility

Antirheumatic drug use with rheumatoid arthritis pregnancies

Jack Cush, MD

A nationwide Norwegian registry study of rheumatoid arthritis (RA) pregnancies showed that while medication use increased during pregnancy, many discontinued treatment during pregnancy, only to resumed it after childbirth.

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2026 Resolutions (1.9.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, announcements and journal articles from this past week on RheumNow.com. More on Variable bendability, a better way to treat RA, and a novel advance for GLP1a in PsA; and 2026 Resolutions!

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100 women w/ severe preeclampsia (PE) compared to 40 pregnant controls. antiphospholipid antibodies (aPL) was significantly more prevalent iin PE women (34% vs 10%) [OR = 4.63]. aPL positivity was also linked to both early and late severe PE [OR = 4-5, p = .008]. https://t.co/YhwplHil1y
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Assess Reproductive Health in SLE Clinic Visits Systemic Lupus Erythematosus (SLE) mainly affects women of childbearing age, increasing their risk of infertility, miscarriages, and pregnancy complications due to disease factors and medications. Rheumatologists should actively https://t.co/hqWSpqJ6HN
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couple holding hands with baby shoes

Assess Reproductive Health in SLE Clinic Visits

Jun Chu , MSN, CRNP

Due to the complexity of SLE, rheumatology providers should take an active role in assessing reproductive health, providing education on how SLE may affect pregnancy, and taking a collaborative, multidisciplinary approach with the patient’s gynecologist.

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Best of 2025: Contraception in SLE Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy. As recently as 2004, https://t.co/vBb0vyqod8
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variety of contraception methods

Best of 2025: Contraception in SLE

Lisa Sammaritano MD

Pregnancy in SLE gets a lot of press in the rheumatology literature, and deservedly so, since pregnancy risks can be markedly increased. It was not that many years ago that women with SLE were counseled to avoid pregnancy.

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QD Clinics - Mission: APP Partners in Care Week 1 QD300: Flare or Beware (featuring Lindsay Tom, PA-C and Phong Nguyen, MD) QD301: CAR-T Cell Therapy for Lupus (featuring Philip Mease, MD and Cayla Alexander, DNP) QD302: Unweanable PMR (featuring Jack Cush, MD, and Leilani Law, https://t.co/Ow2KMAzwGK
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WHO recommendations on GLP-1 agonists: 1) conditional recommendation - GLP-1 drugs can be used for for long-term obesity treatment by adults, except pregnant women; 2) GLP-1a use should be paired with a healthy diet and physical activity. Access to these drugs is a problem. https://t.co/jMa7rbJPby
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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

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

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Japanese ANSWER cohort (3623 RA pts on bDMARDs or JAKi) included looked at T2T in 118 RA pregnancies. 93% had full-term deliveries; 85% w/ remission or LDA maintained throughout preg. 35/118 cont' bDMARDs during preg & had signif lower DAS28-CRP vs those D/C (n 24) (P = 0.007). https://t.co/uG8m7RzSiU
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Postmenopausal women on estrogen hormone therapy (HT) had a modest incr risk (HR 1.33; 1.32-1.35; P < .001). of a new autoimmune Dz over next 5-10 yrs (vs those not on HT) TriNetX study of 889,413 HT vs 2,6 mill (not HT) - 6.7% vs 5.3% developed autoimmune dz at 5 yrs. https://t.co/fsi32XIzLe
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+ANA's are common in pregnancy. Study of 2159 Chinese 1st trimester pregnant women found ANAs positivity in 14.7 % (1:100 most common titer; speckled most common pattern). ANA+ assoc w/ smoking, age 30-34 yrs, multiparity, thyroid Dz & hypertension https://t.co/mRQGajVe3g https://t.co/DqE1KC4Kgo

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Treating During Pregnancy (11.14.2025)

Jack Cush, MD

Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com

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Swedish Birth Registry study of adverse preg outcomes (APOs) after SSc Dx [n=941] or w/in 3 yrs [39] or > 3yrs pre-Dx [839]. SSc women have incr APOs post-Dx, including preeclampsia (RR 3.8), preterm (3.3), C-section (2.5); but also incr APO risk w/in 3 yrs of Dx

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Systematic review of 10 studies showed TNFi exposure in utero not assoc w/ incr risk of infant severe infxn (4 RCTs); same for breast milk exposure (2 RCTs). Infant vaccination outcomes unaffected by TNFi use, but rec delaying BCG vaccination if TNFi exposed https://t.co/02Nn6TuzR3
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Using AI and LLMs in Qualitative Data Dr. Bella Mehta discusses abstract 0794 (Using AI to Analyze Multilingual Qualitative Data in Lupus Pregnancy Research: A Proof of Concept with Large Language Models) presented at #ACR25 https://t.co/HFBuNxdZOF https://t.co/gKAXURq8xR

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Dr. John Cush @RheumNow( View Tweet )
Marketscan claims study of 62,813 IMID women w/ 70,529 pregnancies & 69,412 births, 4,485 (7.1%) were exposed to at least one TNFi during pregnancy & 3,559 postpartum. TNFi use NOT assoc w/ SIE risk during Preg (HR 1.39; 0.95-2.05) or postpartum (HR 1.22; https://t.co/NsxOLpT0ds
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🍼 “Stop breastfeeding if on methotrexate” — that’s what we’ve always heard. But here’s the news 👇 📊 Latest EULAR lactation: Methotrexate = LoE 4 / C ➡️ May be considered in breastfeeding if no safer alternative exists. 💡Not first-line, not forbidden — just evidence-limited. https://t.co/IJEpZYMaFV

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Dr Abhilasha Manwatkar (AIIMS Nagpur) @Abhilasha21822( View Tweet )
Really great visual summaries by Athena Chin, Sam Whittle and colleagues: Recs for the Use DMARDs in Pregnancy and Reproductive Health for Pts w Rheumatic Disease: A Scoping Review - Oct 2025 - Arthritis Care & Research #Rheumatology #MedEdu https://t.co/zRJcTESJWN 🇦🇺 https://t.co/OYZVtLEYr7

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Suleman Bhana, MD @DrBhana( View Tweet )
New Insights into Pregnancy Outcomes and Maternal-Fetal Health in Rheumatic Diseases At #ACR25, the ACR presented new research illuminating critical challenges and advances in pregnancy outcomes for women living with rheumatic diseases, including axial spondyloarthritis, https://t.co/nJjtTMHnD3
Dr. John Cush @RheumNow( View Tweet )
Abstract 2360: Single-center lupus pregnancy cohort found that: 🔹 Absence of DORIS remission associated w/ adverse pregnancy outcomes (Pre-term, Pre-eclampsia) 🔹 This is along with known risk factors: antihypertensive use, prior nephritis, active disease @RheumNow #ACR25 https://t.co/STg1NBeFPo

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Akhil Sood MD, MS @AkhilSoodMD( View Tweet )
Reaadmissions in sle pregnancies from 66k patients Insurance and economics seem to be very important in predictions using machine learning. Abst#2629 #ACR25 @RheumNow https://t.co/x2oo9TOxoh

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Bella Mehta @bella_mehta( View Tweet )
In healthy women, preeclampsia was more common with: - increased calprotectin - decreased anti-CCP (very low levels) during pregnancy & this has good predictive capacity for future preeclampsia. Rheum pathophys can give insights into adjacent pathology #ACR25 ABST2628 @RheumNow https://t.co/7d5YB6n6XJ

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David Liew @drdavidliew( View Tweet )
Anti ccp may be protective for preeclampsia (secondary to NETs) Abst#2628 @RheumNow #ACR25 https://t.co/n3ge0iIiB0

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Bella Mehta @bella_mehta( View Tweet )

Recent Blogs

Best of 2022: Myths & Misconceptions with Febrile Disorders

Rachel Tate, DO
Myth vs reality
Still’s disease and autoinflammatory disorders are rare conditions unified by recurrent fevers and inflammation of skin, joints, and other organs. While labs often support the diagnosis, these conditions are best diagnosed by genetic testing, or by specific criteria (in the absence of a genetic test). The following is a table that lists common misconceptions (myths) and their clarifying explanations. Read Post

Myths & Misconceptions with Febrile Disorders

Rachel Tate, DO
Myth vs reality
Still’s disease and autoinflammatory disorders are rare conditions unified by recurrent fevers and inflammation of skin, joints, and other organs. While labs often support the diagnosis, these conditions are best diagnosed by genetic testing, or by specific criteria (in the absence of a genetic test). The following is a table that lists common misconceptions (myths) and their clarifying explanations. Read Post
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