ABSTRACT

Autoimmune rheumatic diseases are often seen in individuals at reproductive age. Medications used in case of unplanned pregnancy and/or active rheumatic disease may increase the risk of obstetric complications. Knowledge about the medications used during pregnancy is limited and it is usually accumulated over the years as a result of medications exposure during unplanned pregnancies. Recently, European League Against Rheumatology (EULAR) and the British Society of Rheumatology (BSR) and the British Health Professionals in Rheumatology (BHPR) updated and published the guidelines for the management of rheumatic diseases during pregnancy. As Turkish Society for Rheumatology (TRD), we have decided to develop national treatment recommendations for the proper management of anti-rheumatic drugs during pregnancy and lactation in rheumatic diseases. The aim here is to establish guiding "recommendations" on significant matters such as preg-nancy plan and the use of antirheumatic drugs during conception, gestation and lactation periods and vaccination. This guideline was created by a multidisciplinary working group consist of rheumatology, obstetrics and pediatrics physicians. These recommendations are based on the current recommendations of rheumatic drug use during pregnancy by the EULAR, BSR and BHPR. A literature review was conducted by the working group to update existing international recommendations and its references. The draft of recommendations was submitted to TRD members for their preliminary evaluation. After the revised recommendations were created, the final version was submitted to TRD members and voted [scoring 0-10 (0: Strongly disagree, 10: Strongly agree)]. Two meetings were held with the participation of the working group, one on April 7, 2017 for the preliminary evaluation and the planning, and the other on May 6, 2017 for consensus and writing planning on "the draft of recommendations". The draft recommendations prepared were reviewed by TRD members on September 2018. The final version of the recommendations were voted by the members on April 2019.