2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases

作者：Lisa R. Sammaritano, Bonnie Lee Bermas, Eliza E. Chakravarty, Christina Chambers, Megan E. B. Clowse, Michael D. Lockshin, Wendy Marder, Gordon Henry Guyatt, David Ware Branch, Jill P. Buyon, Lisa Christopher‐Stine, Rachelle Crow‐Hercher, John J. Cush, Maurice L. Druzin, Arthur Kavanaugh, Carl A. Laskin, Lauren A. Plante, Jane E. Salmon, Julia Fridman Simard, Emily C. Somers, Virginia Steen, Sara K. Tedeschi, Évelyne Vinet, C. Whitney White, Jinoos Yazdany, Medha Barbhaiya, Brittany A. Bettendorf, Amanda M. Eudy, Arundathi Jayatilleke, Amit Aakash Shah, Nancy Sullivan, Laura L. Tarter, Mehret Birru Talabi, Marat Turgunbaev, Amy S. Turner, Kristen E. D’Anci · 发表于：Arthritis & Rheumatology · 年份：2020 · DOI：10.1002/art.41191 · 被引用次数：791 · 研究领域：Pregnancy and Medication Impact、Rheumatoid Arthritis Research and Therapies、Endometriosis Research and Treatment

OBJECTIVE: To develop an evidence-based guideline on contraception, assisted reproductive technologies (ART), fertility preservation with gonadotoxic therapy, use of menopausal hormone replacement therapy (HRT), pregnancy assessment and management, and medication use in patients with rheumatic and musculoskeletal disease (RMD). METHODS: We conducted a systematic review of evidence relating to contraception, ART, fertility preservation, HRT, pregnancy and lactation, and medication use in RMD populations, using Grading of Recommendations Assessment, Development and Evaluation methodology to rate the quality of evidence and a group consensus process to determine final recommendations and grade their strength (conditional or strong). Good practice statements were agreed upon when indirect evidence was sufficiently compelling that a formal vote was unnecessary. RESULTS: This American College of Rheumatology guideline provides 12 ungraded good practice statements and 131 graded recommendations for reproductive health care in RMD patients. These recommendations are intended to guide care for all patients with RMD, except where indicated as being specific for patients with systemic lupus erythematosus, those positive for antiphospholipid antibody, and/or those positive for anti-Ro/SSA and/or anti-La/SSB antibodies. Recommendations and good practice statements support several guiding principles: use of safe and effective contraception to prevent unplanned pregnancy, pre-pregnancy coun...