The American College of Rheumatology recently published the organization’s first guideline on how to manage reproductive health issues in patients with rheumatic and musculoskeletal diseases (RMDs).

Patients with RMDs face unique challenges as pregnancy may be associated with serious maternal or adverse fetal outcomes; furthermore, it is difficult to avoid use of medications in patients with rheumatic and musculoskeletal diseases, as uncontrolled systemic inflammation may be associated with poor pregnancy outcomes.

This guideline reviews medication use in men and women for preconception, and in women during pregnancy and while breastfeeding. A systematic review of evidence was used to develop clinical recommendations on the following topics:

• Contraception
• Assisted reproductive technology
• Fertility preservation
• Hormone replacement therapy
• Pregnancy
• Lactation
• Medication use

The guideline complements general practice guidelines for safe and effective contraception to prevent unplanned pregnancy, to engage in pre-pregnancy counseling, and for physicians and patients to have ongoing discussions regarding pregnancy.

The full guideline and supporting documents may be accessed through the Reproductive Health in Rheumatic Diseases page on the American College of Rheumatology website.