Managing contraception and pregnancy in the rheumatologic diseases

Best Pract Res Clin Rheumatol. 2010 Jun;24(3):373-85. doi: 10.1016/j.berh.2009.12.004.


Most pregnancies in women with rheumatologic disease will result in the delivery of a healthy baby. Pregnancy can be particularly risky in women with active disease or on teratogenic medications, making contraception an important issue for these women. All women with rheumatologic disease have contraceptive options, including barrier methods, the intra-uterine device and progesterone-only medications. Active inflammatory disease, whether in the form of lupus, systemic vasculitis or myositis, places the pregnancy at increased risk. Pre-eclampsia is a particular risk for women with lupus or antiphospholipid syndrome and may be decreased by daily low-dose aspirin. Rheumatoid arthritis typically improves and does not have a major impact on pregnancy outcomes. The expected post-partum arthritis flare may be avoided by restarting medications soon after delivery. Judicious use of medication and close observation may be the keys to successful pregnancy in women with rheumatologic disease.

Publication types

  • Review

MeSH terms

  • Adult
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / drug therapy
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • Contraception / methods*
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy
  • Myositis / complications
  • Myositis / drug therapy
  • Pregnancy
  • Pregnancy Complications*
  • Pregnancy Outcome*
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / diagnosis
  • Rheumatic Diseases / drug therapy
  • Scleroderma, Limited / complications
  • Scleroderma, Limited / drug therapy
  • Vasculitis / complications
  • Vasculitis / drug therapy


  • Antirheumatic Agents