Pregnancy and rheumatic diseases Published: June 11, 2024

https://www.thelancet.com/series/pregnancy-rheumatic-diseases?dgcid=hubspot_email_infocusalerts-obgyn_feature_lanrhepregnancyrmd24&utm_campaign=infocusalerts-obgyn&utm_medium=email&_hsenc=p2ANqtz-9rZER3yoEQl37Y2w-XNZJzJzhVNR0R5mB3_i-uhgfYmMXX5Dam-uiAr4shV-5e0-jVF3DkKY-d_mIGL49tG_QCRCZvdQ&_hsmi=316510222&utm_content=314995446&utm_source=hs_email Pregnancy can be a time of concern for any individual, particularly for those with chronic conditions. Rheumatic diseases disproportionally affect individuals of childbearing age and active inflammatory disease in pregnancy is associated with an increased risk of adverse pregnancy outcomes. Maintenance of low disease activity with disease-modifying antirheumatic drugs (DMARDs) is the best way to reduce the risks of adverse pregnancy outcomes. However, therapeutic decisions are complicated by scarce data on the efficacy and safety of DMARDs in pregnant people due to exclusion of these individuals from studies, which has led to inappropriate withdrawal of treatment and consequential harm. This Series in The Lancet Rheumatology calls for a reconsideration of therapeutic decisions for treating rheumatic diseases in and around pregnancy to optimise the safe and effective use of DMARDs, proposes solutions to change the challenging landscape around studies in pregnancy, and provides guidance on discussing these topics with patients.