• Kathy Paizis.
• Mercy Hospital for Women, Western Health Sunshine, Austin Health, Melbourne.
• Aust Prescr. 2019 Jun 1; 42 (3): 97-101.

Pregnancy Presents Challenges For Women With Autoimmune Diseases It Is Associated With Significant Physiological Hormonal And Immunomodulatory Changes Which Are Complex And Vary According To The Stage Of PregnancyPregnancy Planning And Counselling Should Be OfferedAutoimmune Diseases Such As Rheumatoid Arthritis Tend To Improve In Pregnancy While Systemic Lupus Erythematosus May Increase In ActivityDuring Pregnancy The Chosen Regimen Should Control Or Prevent Underlying Disease Activity And Minimise Risk To The Fetus Ideally Women Should Be On A Stable Regimen Before ConceptionPoorly Controlled Disease Is Associated With Poor Outcomes For Both Mother And Fetus Such As Higher Risks Of Pre Eclampsia Early Delivery And Growth Restriction Of The FetusPostpartum There Is A Sudden Fall In Hormone Concentrations And A Switch To A Pro Inflammatory State This Increases The Risk Of Relapse Of Many Autoimmune Diseases In Particular Rheumatoid Arthritis Crohn’s Disease And Autoimmune HepatitisMany Drugs Are Compatible With Breastfeeding But There Are Limited Data On Many Of The New Drugs

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