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SAT0591 Consensus Statement for The Evaluation and Management of Patients with Autoimmune and Inflammatory Diseases during Fertility, Pregnancy, Post-Partum and Breastfeeding
  1. J.A. Martínez-Lόpez1,
  2. M.L. García Vivar2,
  3. R. Caliz3,
  4. E. Loza4,
  5. M. Freire5,
  6. M. Galindo6,
  7. M.V. Hernández7,
  8. F.J. Lόpez Longo8,
  9. V. Martínez Taboada9,10,
  10. J.M. Pego Reigosa11,
  11. E. Rubio12,
  12. E. Trujillo13,
  13. P. Vela-Casasempere14
  1. 1Rheumatology Unit, Hospital Universitario Fundaciόn Jiménez Díaz, Madrid
  2. 2Rheumatology Unit, Hospital de Basurto, Bilbao
  3. 3Unidad de Gestiόn de Reumatología, Complejo Hospitalario Universitario de Granada, Granada
  4. 4INMUSC, Madrid
  5. 5Rheumatology Unit, Complexo hospitalario Universitario A Coruña (CHUAC)., A Coruña
  6. 6Rheumatology Unit, Hospital Universitario 12 de Octubre, Madrid
  7. 7Rheumatology Unit, Hospital Clínic de Barcelona, Barcelona
  8. 8Rheumatology Unit, Hospital General Universitario Gregorio Marañόn, Madrid
  9. 9Rheumatology Unit, Hospital Universitario Marqués de Valdecilla
  10. 10Facultad de Medicina, Universidad de Cantabria, Santander
  11. 11Rheumatology Unit, Meixoieiro-Complexo Hospitalario Universitario de Vigo, Vigo
  12. 12Rheumatology Unit, Hospital Universitario Virgen del Rocío, Sevilla
  13. 13Rheumatology Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife
  14. 14Rheumatology Unit, Hospital General Universitario de Alicante, Alicante, Spain

Abstract

Background Nowadays there is a great variability in evaluation and management of patients with autoimmune and inflammatory diseases during fertility, pregnancy, post-partum and breastfeeding, in part due to lack of knowledge.

Objectives To develop recommendations on the evaluation and management of patients with autoimmune and inflammatory diseases during fertility, pregnancy, post-partum and breastfeeding based on the best evidence and experience.

Methods Recommendations were generated following nominal group methodology and Delphi technique. A panel of experts was established (12 rheumatologists). A systematic literature review and a narrative review (websites, clinical guidelines and other relevant documentation) were performed and presented to the panel in the 1st panel meeting to be discussed and to help define recommendations. A first draft of recommendations was generated and circulated for comments and wording refinements. A national survey analyzing different aspects of this topic was undertaken separately. Then, a Delphi process (2 rounds) was carried out. Recommendations were voted from 1 (total disagreement) to 10 (total agreement). We defined agreement if at least 70% voted ≥7. The level of evidence and grade or recommendation was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence.

Results A total of 14 recommendations (see figure) were generated on the pre-conception period (oral and hormonal anticonception, reproductive techniques), pregnancy (planning, treatment and follow-up), and breastfeeding (treatment and follow-up). High risk situations were included as lupus or antiphospholipid syndrome. A consensus >90% was reached in all but one recommendation.

Conclusions These recommendations are intended to provide rheumatologists, patients, families and other stakeholders a consensus on the evaluation and management of patients with autoimmune and inflammatory diseases during fertility, pregnancy, post-partum and breastfeeding.

Disclosure of Interest None declared

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