A nurse is collecting data from a client who is taking prednisone for rheumatoid arthritis

1. Wallenius M, Salvesen KA, Daltveit AK, Skomsvoll JF. Rheumatoid arthritis and outcomes in first and subsequent births based on data from a national birth registry. Acta Obstet Gynecol Scand. 2014;93(3):302–307. [PubMed] [Google Scholar]

2. Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955–2007. Arthritis Rheum. 2010;62(6):1576–1582. [PMC free article] [PubMed] [Google Scholar]

3. Cush JJ, Kavanaugh A. Editorial: pregnancy and rheumatoid arthritis–do not let the perfect become the enemy of the good. Curr Opin Rheumatol. 2014;26(3):299–301. [PubMed] [Google Scholar]

4. de Man YA, Dolhain RJ, van de Geijn FE, Willemsen SP, Hazes JM. Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study. Arthritis Rheum. 2008;59(9):1241–1248. [PubMed] [Google Scholar]

5. Østensen M. Contraception and pregnancy counselling in rheumatoid arthritis. Curr Opin Rheumatol. 2014;26(3):302–307. [PubMed] [Google Scholar]

6. Wallenius M, Skomsvoll JF, Irgens LM, et al. Parity in patients with chronic inflammatory arthritides childless at time of diagnosis. Scand J Rheumatol. 2012;41(3):202–207. [PubMed] [Google Scholar]

7. Katz PP. Childbearing decisions and family size among women with rheumatoid arthritis. Arthritis Rheum. 2006;55(2):217–223. [PubMed] [Google Scholar]

8. Frisell T, Holmqvist M, Kallberg H, Klareskog L, Alfredsson L, Askling J. Familial risks and heritability of rheumatoid arthritis: role of rheumatoid factor/anti-citrullinated protein antibody status, number and type of affected relatives, sex, and age. Arthritis Rheum. 2013;65(11):2773–2782. [PubMed] [Google Scholar]

9. Clowse ME, Chakravarty E, Costenbader KH, Chambers C, Michaud K. Effects of infertility, pregnancy loss, and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2012;64(5):668–674. [PubMed] [Google Scholar]

10. Brouwer J, Laven JS, Hazes JM, Schipper I, Dolhain RJ. Levels of serum anti-Mullerian hormone, a marker for ovarian reserve, in women with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2013;65(9):1534–1538. [PubMed] [Google Scholar]

11. Jawaheer D, Zhu JL, Nohr EA, Olsen J. Time to pregnancy among women with rheumatoid arthritis. Arthritis Rheum. 2011;63(6):1517–1521. [PMC free article] [PubMed] [Google Scholar]

12. Brouwer J, Hazes JM, Laven JS, Dolhain RJ. Fertility in women with rheumatoid arthritis: influence of disease activity and medication. Ann Rheum Dis. 2015;74(10):1836–1841. [PubMed] [Google Scholar]

13. Nørgaard M, Larsson H, Pedersen L, et al. Rheumatoid arthritis and birth outcomes: a Danish and Swedish nationwide prevalence study. J Intern Med. 2010;268(4):329–337. [PubMed] [Google Scholar]

14. Wallenius M, Skomsvoll JF, Irgens LM, et al. Pregnancy and delivery in women with chronic inflammatory arthritides with a specific focus on first birth. Arthritis Rheum. 2011;63(6):1534–1542. [PubMed] [Google Scholar]

15. Hench PS. The ameliorating of pregnancy on chronic atrophic (infectious, rheumatoid) arthritis, fibrositis and intermittent hydrarthrosis. Proc Staff Meet Mayo Clin. 1938;13:161–167. [Google Scholar]

16. Barrett JH, Brennan P, Fiddler M, Silman AJ. Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. Arthritis Rheum. 1999;42(6):1219–1227. [PubMed] [Google Scholar]

17. de Man YA, Hazes JM, van de Geijn FE, Krommenhoek C, Dolhain RJ. Measuring disease activity and functionality during pregnancy in patients with rheumatoid arthritis. Arthritis Rheum. 2007;57(5):716–722. [PubMed] [Google Scholar]

18. de Man YA, Bakker-Jonges LE, Goorbergh CM, et al. Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy. Ann Rheum Dis. 2010;69(2):420–423. [PubMed] [Google Scholar]

19. Reed SD, Vollan TA, Svec MA. Pregnancy outcomes in women with rheumatoid arthritis in Washington State. Matern Child Health J. 2006;10(4):361–366. [PubMed] [Google Scholar]

20. Lin HC, Chen SF, Chen YH. Increased risk of adverse pregnancy outcomes in women with rheumatoid arthritis: a nationwide population-based study. Ann Rheum Dis. 2010;69(4):715–717. [PubMed] [Google Scholar]

21. de Man YA, Hazes JM, van der Heide H, et al. Association of higher rheumatoid arthritis disease activity during pregnancy with lower birth weight: results of a national prospective study. Arthritis Rheum. 2009;60(11):3196–3206. [PubMed] [Google Scholar]

22. Rom AL, Wu CS, Olsen J, et al. Fetal growth and preterm birth in children exposed to maternal or paternal rheumatoid arthritis: a nationwide cohort study. Arthritis Rheumatol. 2014;66(12):3265–3273. [PMC free article] [PubMed] [Google Scholar]

23. Bharti B, Lee SJ, Lindsay SP, et al. Disease severity and pregnancy outcomes in women with rheumatoid arthritis: results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. J Rheumatol. 2015;42(8):1376–1382. [PubMed] [Google Scholar]

24. Bowden AP, Barrett JH, Fallow W, Silman AJ. Women with inflammatory polyarthritis have babies of lower birth weight. J Rheumatol. 2001;28(2):355–359. [PubMed] [Google Scholar]

25. Østensen M, Khamashta M, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8(3):209. [PMC free article] [PubMed] [Google Scholar]

26. Panchal S, Khare M, Moorthy A, Samanta A. Catch me if you can: a national survey of rheumatologists and obstetricians on the use of DMARDs during pregnancy. Rheumatol Int. 2013;33(2):347–353. [PubMed] [Google Scholar]

27. Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. [Accessed October 10, 2015]. Available from: https://www.federalregister.gov/articles/2014/12/04/2014-28241/content-and-format-of-labeling-for-human-prescription-drug-and-biological-products-requirements-for. [PubMed]

28. Nielsen GL, Sorensen HT, Larsen H, Pedersen L. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ. 2001;322(7281):266–270. [PMC free article] [PubMed] [Google Scholar]

29. Nielsen GL, Skriver MV, Pedersen L, Sorensen HT. Danish group reanalyses miscarriage in NSAID users. BMJ. 2004;328(7431):109. [PMC free article] [PubMed] [Google Scholar]

30. Li DK, Liu L, Odouli R. Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study. BMJ. 2003;327(7411):368. [PMC free article] [PubMed] [Google Scholar]

31. Edwards DR, Aldridge T, Baird DD, Funk MJ, Savitz DA, Hartmann KE. Periconceptional over-the-counter nonsteroidal anti-inflammatory drug exposure and risk for spontaneous abortion. Obstet Gynecol. 2012;120(1):113–122. [PMC free article] [PubMed] [Google Scholar]

32. Nezvalová-Henriksen K, Spigset O, Nordeng H. Effects of ibuprofen, diclofenac, naproxen, and piroxicam on the course of pregnancy and pregnancy outcome: a prospective cohort study. BJOG. 2013;120(8):948–959. [PMC free article] [PubMed] [Google Scholar]

33. Koren G, Florescu A, Costei AM, Boskovic R, Moretti ME. Nonsteroidal antiinflammatory drugs during third trimester and the risk of premature closure of the ductus arteriosus: a meta-analysis. Ann Pharmacother. 2006;40(5):824–829. [PubMed] [Google Scholar]

34. Kuriya B, Hernández-Díaz S, Liu J, Bermas BL, Daniel G, Solomon DH. Patterns of medication use during pregnancy in rheumatoid arthritis. Arthritis Care Res (Hoboken) 2011;63(5):721–728. [PubMed] [Google Scholar]

35. Gur C, Diav-Citrin O, Shechtman S, Arnon J, Ornoy A. Pregnancy outcome after first trimester exposure to corticosteroids: a prospective controlled study. Reprod Toxicol. 2004;18(1):93–101. [PubMed] [Google Scholar]

36. Park-Wyllie L, Mazzotta P, Pastuszak A, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000;62(6):385–392. [PubMed] [Google Scholar]

37. Schardein JL. Chemically Induced Birth Defects. 2nd ed. New York: Marcel Dekker; 1993. [Google Scholar]

38. Methotrexate [package insert] 2011. [Accessed June 26, 2015]. Available from: http://www.pfizer.ca/sites/g/files/g10017036/f/201410/Methotrexate_0.pdf.

39. Martin MC, Barbero P, Groisman B, Aguirre MA, Koren G. Methotrexate embryopathy after exposure to low weekly doses in early pregnancy. Reprod Toxicol. 2014;43:26–29. [PubMed] [Google Scholar]

40. Buckley LM, Bullaboy CA, Leichtman L, Marquez M. Multiple congenital anomalies associated with weekly low-dose methotrexate treatment of the mother. Arthritis Rheum. 1997;40(5):971–973. [PubMed] [Google Scholar]

41. Weber-Schoendorfer C, Chambers C, Wacker E, et al. Pregnancy outcome after methotrexate treatment for rheumatic disease prior to or during early pregnancy: a prospective multicenter cohort study. Arthritis Rheumatol. 2014;66(5):1101–1110. [PubMed] [Google Scholar]

42. Martinez Lopez JA, Loza E, Carmona L. Systematic review on the safety of methotrexate in rheumatoid arthritis regarding the reproductive system (fertility, pregnancy, and breastfeeding) Clin Exp Rheumatol. 2009;27(4):678–684. [PubMed] [Google Scholar]

43. Diav-Citrin O, Blyakhman S, Shechtman S, Ornoy A. Pregnancy outcome following in utero exposure to hydroxychloroquine: a prospective comparative observational study. Reprod Toxicol. 2013;39:58–62. [PubMed] [Google Scholar]

44. Sperber K, Hom C, Chao CP, Shapiro D, Ash J. Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases. Pediatr Rheumatol Online J. 2009;7:9. [PMC free article] [PubMed] [Google Scholar]

45. Levy RA, Vilela VS, Cataldo MJ, et al. Hydroxychloroquine (HCQ) in lupus pregnancy: double-blind and placebo-controlled study. Lupus. 2001;10(6):401–404. [PubMed] [Google Scholar]

46. De Carolis S, Botta A, Salvi S, et al. Is there any role for the hydroxychloroquine (HCQ) in refractory obstetrical antiphospholipid syndrome (APS) treatment? Autoimmun Rev. 2015;14(9):760–762. [PubMed] [Google Scholar]

47. Hydroxychloroquine [package insert] 2012. [Accessed August 15, 2015]. Available from: http://products.sanofi.ca/en/plaquenil.pdf.

48. Rahimi R, Nikfar S, Rezaie A, Abdollahi M. Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis. Reprod Toxicol. 2008;25(2):271–275. [PubMed] [Google Scholar]

49. Nørgård B, Pedersen L, Christensen LA, Sørensen HT. Therapeutic drug use in women with Crohn’s disease and birth outcomes: a Danish nationwide cohort study. Am J Gastroenterol. 2007;102(7):1406–1413. [PubMed] [Google Scholar]

50. Bokström H, Holst RM, Hafström O, et al. Fetal hemolytic anemia associated with maternal sulfasalazine therapy during pregnancy. Acta Obstet Gynecol Scand. 2006;85(1):118–121. [PubMed] [Google Scholar]

51. Levi S, Liberman M, Levi AJ, Bjarnason I. Reversible congenital neutropenia associated with maternal sulphasalazine therapy. Eur J Pediatr. 1988;148(2):174–175. [PubMed] [Google Scholar]

52. Sulfasalazine [package insert] 2014. [Accessed June 26, 2015]. Available from: http://labeling.pfizer.com/ShowLabeling.aspx?id=524.

53. Leflunomide [package insert] 2014. [Accessed June 26, 2015]. Available from: http://products.sanofi.us/arava/arava.html.

54. Chambers CD, Johnson DL, Robinson LK, et al. Birth outcomes in women who have taken leflunomide during pregnancy. Arthritis Rheum. 2010;62(5):1494–1503. [PMC free article] [PubMed] [Google Scholar]

55. Cassina M, Johnson DL, Robinson LK, et al. Pregnancy outcome in women exposed to leflunomide before or during pregnancy. Arthritis Rheum. 2012;64(7):2085–2094. [PubMed] [Google Scholar]

56. Azathioprine [package insert] 2011. [Accessed June 12, 2015]. Available from: http://www.tritonpharma.ca/uploads/files/pdf/imuran-tablet-en.pdf.

57. Mozaffari S, Abdolghaffari AH, Nikfar S, Abdollahi M. Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor necrosis factor drugs: a systematic review with meta-analysis. Hum Exp Toxicol. 2015;34(5):445–459. [PubMed] [Google Scholar]

58. Carter JD, Valeriano J, Vasey FB. Tumor necrosis factor-alpha inhibition and VATER association: a causal relationship. J Rheumatol. 2006;33(5):1014–1017. [PubMed] [Google Scholar]

59. Carter JD, Ladhani A, Ricca LR, Valeriano J, Vasey FB. A safety assessment of tumor necrosis factor antagonists during pregnancy: a review of the Food and Drug Administration database. J Rheumatol. 2009;36(3):635–641. [PubMed] [Google Scholar]

60. Verstappen SM, King Y, Watson KD, Symmons DP, Hyrich KL. Anti-TNF therapies and pregnancy: outcome of 130 pregnancies in the British Society for Rheumatology Biologics Register. Ann Rheum Dis. 2011;70(5):823–826. [PMC free article] [PubMed] [Google Scholar]

61. Diav-Citrin O, Otcheretianski-Volodarsky A, Shechtman S, Ornoy A. Pregnancy outcome following gestational exposure to TNF-alpha-inhibitors: a prospective, comparative, observational study. Reprod Toxicol. 2014;43:78–84. [PubMed] [Google Scholar]

62. Mahadevan U, Martin CF, Sandler RS, et al. PIANO: a 1000 patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic therapy. Gastroenterology. 2012;142:S149. [Google Scholar]

63. Weber-Schoendorfer C, Oppermann M, Wacker E, et al. Pregnancy outcome after TNF-alpha inhibitor therapy during the first trimester: a prospective multicentre cohort study. Br J Clin Pharmacol. 2015;80(4):727–739. [PMC free article] [PubMed] [Google Scholar]

64. Katz JA, Antoni C, Keenan GF, Smith DE, Jacobs SJ, Lichtenstein GR. Outcome of pregnancy in women receiving infliximab for the treatment of Crohn’s disease and rheumatoid arthritis. Am J Gastroenterol. 2004;99(12):2385–2392. [PubMed] [Google Scholar]

65. Lichtenstein GR, Feagan BG, Cohen RD, et al. Serious infection and mortality in patients with Crohn’s disease: more than 5 years of follow-up in the TREAT registry. Am J Gastroenterol. 2012;107(9):1409–1422. [PMC free article] [PubMed] [Google Scholar]

66. Chambers C, Johnson D, Jones KL, OTIS Collaborative Research Group Pregnancy outcome in women exposed to anti-TNF-alpha medications: the OTIS rheumatoid arthritis in pregnancy study. Arthritis Rheumatol. 2004;50(9):S479. Abstract 1224. [Google Scholar]

67. Mahadevan U, Wolf DC, Dubinsky M, et al. Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2013;11(3):286–292. quiz e224. [PMC free article] [PubMed] [Google Scholar]

68. Cheent K, Nolan J, Shariq S, Kiho L, Pal A, Arnold J. Case report: fatal case of disseminated BCG infection in an infant born to a mother taking infliximab for Crohn’s disease. J Crohns Colitis. 2010;4(5):603–605. [PubMed] [Google Scholar]

69. Adalimumab [package insert] 2002. [Accessed May 15, 2015]. Available from: http://www.rxabbvie.com/pdf/humira.pdf.

70. Certolizumab [package insert] 2013. [Accessed July 20, 2015]. Available from: http://www.cimzia.com/pdf/prescribing_information.pdf.

71. Etanercept [package insert] 2013. [Accessed August 1, 2015]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2003/etanimm060503LB.pdf.

72. Golimumab [package insert] 2014. [Accessed August 1, 2015]. Available from: http://www.simponi.com/shared/product/simponi/prescribing-information.pdf.

73. Infliximab [package insert] 2013. [Accessed August 2, 2015]. Available from: http://www.remicade.com/shared/product/remicade/prescribing-information.pdf.

74. Pham T, Bachelez H, Berthelot JM, et al. Abatacept therapy and safety management. Joint Bone Spine. 2012;79(Suppl 1):3–84. [PubMed] [Google Scholar]

75. Kumar M, Ray L, Vemuri S, Simon TA. Pregnancy outcomes following exposure to abatacept during pregnancy. Semin Arthritis Rheum. 2015;45(3):351–356. [PubMed] [Google Scholar]

76. Abatacept [package insert] 2015. [Accessed June 29, 2015]. Available from: http://packageinserts.bms.com/pi/pi_orencia.pdf.

77. Rituximab [package insert] 2014. [Accessed August 2, 2015]. http://www.gene.com/download/pdf/rituxan_prescribing.pdf.

78. Chakravarty EF, Murray ER, Kelman A, Farmer P. Pregnancy outcomes after maternal exposure to rituximab. Blood. 2011;117(5):1499–1506. [PubMed] [Google Scholar]

79. Mandal PK, Dolai TK, Bagchi B, Ghosh MK, Bose S, Bhattacharyya M. B cell suppression in newborn following treatment of pregnant diffuse large B-cell lymphoma patient with rituximab containing regimen. Indian J Pediatr. 2014;81(10):1092–1094. [PubMed] [Google Scholar]

80. Anakinra [package insert] 2013. [Accessed July 15, 2015]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2003/anakamg062703LB.pdf.

81. Chang Z, Spong CY, Jesus AA, et al. Anakinra use during pregnancy in patients with cryopyrin-associated periodic syndromes (CAPS) Arthritis Rheumatol. 2014;66(11):3227–3232. [PMC free article] [PubMed] [Google Scholar]

82. Fischer-Betz R, Specker C, Schneider M. Successful outcome of two pregnancies in patients with adult-onset Still’s disease treated with IL-1 receptor antagonist (anakinra) Clin Exp Rheumatol. 2011;29(6):1021–1023. [PubMed] [Google Scholar]

83. Berger CT, Recher M, Steiner U, Hauser TM. A patient’s wish: anakinra in pregnancy. Ann Rheum Dis. 2009;68(11):1794–1795. [PubMed] [Google Scholar]

84. Tocilizumab [package insert] 2014. [Accessed July 25, 2015]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/125276lbl.pdf.

85. Rubbert-Roth A, Goupille P, Moosavi S, Hou A. First experiences with pregnancies in RA patients receiving tocilizumab therapy. Arthritis Rheumatol. 2010;62(Suppl 10):384. [Google Scholar]

86. Tofacitinib [package insert] 2015. [Accessed August 1, 2015]. Available from: http://www.xeljanz.com/

87. Brent RL. Teratogen update: reproductive risks of leflunomide (Arava); a pyrimidine synthesis inhibitor: counseling women taking leflunomide before or during pregnancy and men taking leflunomide who are contemplating fathering a child. Teratology. 2001;63(2):106–112. [PubMed] [Google Scholar]

88. Barrett JH, Brennan P, Fiddler M, Silman A. Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis. Arthritis Rheum. 2000;43(5):1010–1015. [PubMed] [Google Scholar]

89. Ost L, Wettrell G, Björkhem I, Rane A. Prednisolone excretion in human milk. J Pediatr. 1985;106(6):1008–1011. [PubMed] [Google Scholar]

90. American Academy of Pediatrics Committee on Drugs Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776–789. [PubMed] [Google Scholar]

91. Rigourd V, de Villepin B, Amirouche A, et al. Ibuprofen concentrations in human mature milk–first data about pharmacokinetics study in breast milk with AOR-10127 “Antalait” study. Ther Drug Monit. 2014;36(5):590–596. [PubMed] [Google Scholar]

92. LactMed: ibuprofen [Accessed June 25, 2015]. Available from: http://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm.

93. Motta M, Tincani A, Faden D, et al. Follow-up of infants exposed to hydroxychloroquine given to mothers during pregnancy and lactation. J Perinatol. 2005;25(2):86–89. [PubMed] [Google Scholar]

94. Cimaz R, Brucato A, Meregalli E, Muscará M, Sergi P. Electroretinograms of children born to mothers treated with hydroxychloroquine during pregnancy and breast-feeding: comment on the article by Costedoat-Chalumeau et al. Arthritis Rheum. 2004;50(9):3056–3057. author reply 3057–3058. [PubMed] [Google Scholar]

95. Costedoat-Chalumeau N, Amoura Z, Aymard G, et al. Evidence of transplacental passage of hydroxychloroquine in humans. Arthritis Rheum. 2002;46(4):1123–1124. [PubMed] [Google Scholar]

96. Esbjörner E, Järnerot G, Wranne L. Sulphasalazine and sulphapyridine serum levels in children to mothers treated with sulphasalazine during pregnancy and lactation. Acta Paediatr Scand. 1987;76(1):137–142. [PubMed] [Google Scholar]

97. Branski D, Kerem E, Gross-Kieselstein E, Hurvitz H, Litt R, Abrahamov A. Bloody diarrhea--a possible complication of sulfasalazine transferred through human breast milk. J Pediatr Gastroenterol Nutr. 1986;5(2):316–317. [PubMed] [Google Scholar]

98. Moretti ME, Verjee Z, Ito S, Koren G. Breast-feeding during maternal use of azathioprine. Ann Pharmacother. 2006;40(12):2269–2272. [PubMed] [Google Scholar]

99. Sau A, Clarke S, Bass J, Kaiser A, Marinaki A, Nelson-Piercy C. Azathioprine and breastfeeding: is it safe? BJOG. 2007;114(4):498–501. [PubMed] [Google Scholar]

100. Angelberger S, Reinisch W, Messerschmidt A, et al. Long-term follow-up of babies exposed to azathioprine in utero and via breastfeeding. J Crohns Colitis. 2011;5(2):95–100. [PubMed] [Google Scholar]

101. Bernard N, Gouraud A, Paret N, Cottin J, Descotes J, Vial T. Azathioprine and breastfeeding: long-term follow-up. Fundam Clin Pharmacol. 2013;27(Suppl 1):12. Abstract 05-03. [Google Scholar]

102. Johns DG, Rutherford LD, Leighton PC, Vogel CL. Secretion of methotrexate into human milk. Am J Obstet Gynecol. 1972;112(7):978–980. [PubMed] [Google Scholar]

103. Thorne JC, Nadarajah T, Moretti M, Ito S. Methotrexate use in a breastfeeding patient with rheumatoid arthritis. J Rheumatol. 2014;41(11):2332. [PubMed] [Google Scholar]

104. van der Woude CJ, Kolacek S, Dotan I, et al. European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohns Colitis. 2010;4(5):493–510. [PubMed] [Google Scholar]

105. Vasiliauskas EA, Church JA, Silverman N, Barry M, Targan SR, Dubinsky MC. Case report: evidence for transplacental transfer of maternally administered infliximab to the newborn. Clin Gastroenterol Hepatol. 2006;4(10):1255–1258. [PubMed] [Google Scholar]

106. Kane S, Ford J, Cohen R, Wagner C. Absence of infliximab in infants and breast milk from nursing mothers receiving therapy for Crohn’s disease before and after delivery. J Clin Gastroenterol. 2009;43(7):613–616. [PubMed] [Google Scholar]

107. Ben-Horin S, Yavzori M, Kopylov U, et al. Detection of infliximab in breast milk of nursing mothers with inflammatory bowel disease. J Crohns Colitis. 2011;5(6):555–558. [PubMed] [Google Scholar]

108. Ben-Horin S, Yavzori M, Katz L, et al. Adalimumab level in breast milk of a nursing mother. Clin Gastroenterol Hepatol. 2010;8(5):475–476. [PubMed] [Google Scholar]

109. Murashima A, Watanabe N, Ozawa N, Saito H, Yamaguchi K. Etanercept during pregnancy and lactation in a patient with rheumatoid arthritis: drug levels in maternal serum, cord blood, breast milk and the infant’s serum. Ann Rheum Dis. 2009;68(11):1793–1794. [PubMed] [Google Scholar]

110. Keeling S, Wolbink GJ. Measuring multiple etanercept levels in the breast milk of a nursing mother with rheumatoid arthritis. J Rheumatol. 2010;37(7):1551. [PubMed] [Google Scholar]

111. Ostensen M, Eigenmann GO. Etanercept in breast milk. J Rheumatol. 2004;31(5):1017–1018. [PubMed] [Google Scholar]

112. Wallenius M, Lie E, Daltveit AK, et al. No excess risks in offspring with paternal preconception exposure to disease-modifying antirheumatic drugs. Arthritis Rheumatol. 2015;67(1):296–301. [PubMed] [Google Scholar]

113. Sussman A, Leonard JM. Psoriasis, methotrexate, and oligospermia. Arch Dermatol. 1980;116(2):215–217. [PubMed] [Google Scholar]

114. Grunnet E, Nyfors A, Hansen KB. Studies of human semen in topical corticosteroid-treated and in methotrexate-treated psoriatics. Dermatologica. 1977;154(2):78–84. [PubMed] [Google Scholar]

115. Morris LF, Harrod MJ, Menter MA, Silverman AK. Methotrexate and reproduction in men: case report and recommendations. J Am Acad Dermatol. 1993;29(5 Pt 2):913–916. [PubMed] [Google Scholar]

116. Weber-Schoendorfer C, Hoeltzenbein M, Wacker E, Meister R, Schaefer C. No evidence for an increased risk of adverse pregnancy outcome after paternal low-dose methotrexate: an observational cohort study. Rheumatology (Oxford) 2014;53(4):757–763. [PubMed] [Google Scholar]

117. O’Moráin C, Smethurst P, Doré CJ, Levi AJ. Reversible male infertility due to sulphasalazine: studies in man and rat. Gut. 1984;25(10):1078–1084. [PMC free article] [PubMed] [Google Scholar]

118. Nørgård B, Pedersen L, Jacobsen J, Rasmussen SN, Sørensen HT. The risk of congenital abnormalities in children fathered by men treated with azathioprine or mercaptopurine before conception. Aliment Pharmacol Ther. 2004;19(6):679–685. [PubMed] [Google Scholar]

119. Teruel C, López-San Román A, Bermejo F, et al. Outcomes of pregnancies fathered by inflammatory bowel disease patients exposed to thiopurines. Am J Gastroenterol. 2010;105(9):2003–2008. [PubMed] [Google Scholar]

120. De Santis M, Straface G, Cavaliere A, Carducci B, Caruso A. Paternal and maternal exposure to leflunomide: pregnancy and neonatal outcome. Ann Rheum Dis. 2005;64(7):1096–1097. [PMC free article] [PubMed] [Google Scholar]

121. Mahadevan U, Terdiman JP, Aron J, Jacobsohn S, Turek P. Infliximab and semen quality in men with inflammatory bowel disease. Inflamm Bowel Dis. 2005;11(4):395–399. [PubMed] [Google Scholar]

122. Wildi LM, Haraoui B. Reversible male infertility under treatment with an anti-TNFalpha agent: a case report. Ann Rheum Dis. 2012;71(3):473–474. [PubMed] [Google Scholar]

123. Villiger PM, Caliezi G, Cottin V, Forger F, Senn A, Østensen M. Effects of TNF antagonists on sperm characteristics in patients with spondyloarthritis. Ann Rheum Dis. 2010;69(10):1842–1844. [PubMed] [Google Scholar]

124. Paschou S, Voulgari PV, Vrabie IG, Saougou IG, Drosos AA. Fertility and reproduction in male patients with ankylosing spondylitis treated with infliximab. J Rheumatol. 2009;36(2):351–354. [PubMed] [Google Scholar]

125. Food and Drug Administration Code of Federal Regulations Title 21. [Accessed January 5, 2014]. Available from: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?fr=201.57.

Page 2

Approach to disease-modifying therapy for pregnant women with RA (or for women wishing to conceive)