Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Rheumatology (Oxford). 2011 Nov;50(11):1955-68. doi: 10.1093/rheumatology/ker302. Epub 2011 Sep 2.
It has long been known that pregnancy and childbirth have a profound effect on the disease activity of rheumatic diseases. For clinicians, the management of patients with RA wishing to become pregnant involves the challenge of keeping disease activity under control and adequately adapting drug therapy during pregnancy and post-partum. This article aims to summarize the current evidence on the evolution of RA disease activity during and after pregnancy and the use of anti-rheumatic drugs around this period. Of recent interest is the potential use of anti-TNF compounds in the preconception period and during pregnancy. Accumulating experience with anti-TNF therapy in other immune-mediated inflammatory diseases, such as Crohn's disease, provides useful insights for the use of TNF blockade in pregnant women with RA, or RA patients wishing to become pregnant.
长期以来，人们已经知道怀孕和分娩对风湿性疾病的疾病活动有深远的影响。对于临床医生来说，管理希望怀孕的 RA 患者涉及到控制疾病活动的挑战，以及在怀孕期间和产后充分调整药物治疗。本文旨在总结目前关于 RA 疾病活动在怀孕期间和产后的演变以及在此期间使用抗风湿药物的证据。最近人们关注的是在受孕前和怀孕期间使用抗 TNF 化合物的可能性。在其他免疫介导的炎症性疾病（如克罗恩病）中积累的抗 TNF 治疗经验，为 RA 孕妇或希望怀孕的 RA 患者使用 TNF 阻断提供了有用的见解。
