As therapies for rheumatic diseases have improved the well-being of patients, women with these diseases are increasingly interested in pregnancy. However, underlying rheumatologic disease increases the health risks for both mother and baby. Pregnant women are at risk for disease flare, organ damage, preeclampsia, and death. Beyond a high rate of fetal loss, offspring are at risk for long-term health consequences from preterm birth and fetal growth restriction. These risks make appropriate management of rheumatologic disease in pregnancy essential, but how best to manage to do this remains unclear. This international conference will bring together worldwide leaders in this field to share existing data, clinical experience, and areas of potential study. These interchanges will help to formulate treatment strategies and research ideas that will ultimately impact patient care. This three day conference continues the two-decade tradition of international biennial meetings among leading experts in the field of pregnancy in rheumatic diseases. This meeting has not taken place in the U.S. since 2002 and will give US providers interested in this area an opportunity to participate. The conference will have two overarching goals: 1.) to update researchers in this field about new study results and research methods; and 2.) to aggregate the knowledge and practices of experts in this field to disseminate information to the wider rheumatology and obstetrics communities. An adjunct goal is to facilitate networking to build collaborative research. The first goal of sharing knowledge will be met through a series of short lectures and abstract presentations. The results of two large recently-completed U.S.-based studies of pregnancy in rheumatologic disease will be presented and the ramifications of the findings will be discussed. A concurrent session will focus on novel approaches to research, to both inspire new research projects and to structure research in clinically meaningful and aligned formats. Special attention will be made to encourage trainee involvement through presentations of abstracts and challenging cases. The second goal of disseminating the findings of the conference will be accomplished through manuscripts. The first will address the new FDA Pregnancy and Lactation Labeling Rule. This will include information about how to interpret animal, human and lactation data, and an assessment of the background risk of pregnancy from systemic lupus and rheumatoid arthritis. This paper will guide clinicians in choosing rheumatologic therapies. The second manuscript will compile the practices of experts in screening, prevention, and management of congenital heart block (CHB) from neonatal lupus, as current practice in this area is widely variable. This will be accomplished through a pre-meeting questionnaire, followed by a discussion of the results and the existing data with summary recommendations. A State of the Art paper will report challenging cases and opinions on their management, other important presentations. This conference will be interactive, provide ample time for networking, and foster collaboration between experts and trainees. It will galvanize the U.S-based efforts in this field and promote future coordinated research efforts.

Public Health Relevance

Pregnancy in rheumatologic diseases has assumed greater importance as better treatments for disease allow more women to pursue pregnancy. The management of rheumatologic disease in pregnancy is complicated, with limited data to guide decision-making. This conference will bring together experts to share new data, learn new research strategies, and build new collaborative teams to advance the care of these challenging pregnancies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Conference (R13)
Project #
1R13AR070007-01
Application #
9126021
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Witter, James
Project Start
2016-03-15
Project End
2017-02-28
Budget Start
2016-03-15
Budget End
2017-02-28
Support Year
1
Fiscal Year
2016
Total Cost
$15,000
Indirect Cost
Name
Duke University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Bermas, Bonnie L; Tassinari, Melissa; Clowse, Megan et al. (2018) The new FDA labeling rule: impact on prescribing rheumatological medications during pregnancy. Rheumatology (Oxford) 57:v2-v8
Chambers, Christina; Johnson, Diana L; Kiernan, Elizabeth (2018) Approach to evaluating pregnancy safety of anti-rheumatic medications in the OTIS MotherToBaby pregnancy studies: what have we learned? Rheumatology (Oxford) 57:v34-v39
Clowse, Megan E B; Eudy, Amanda M; Kiernan, Elizabeth et al. (2018) The prevention, screening and treatment of congenital heart block from neonatal lupus: a survey of provider practices. Rheumatology (Oxford) 57:v9-v17
Edens, Cuoghi; Rodrigues, Bruna Costa; Lacerda, Marcela Ignacchiti et al. (2018) Challenging cases in rheumatic pregnancies. Rheumatology (Oxford) 57:v18-v25
Kim, Seoyoung C; Feldman, Sarah; Moscicki, Anna-Barbara (2018) Risk of human papillomavirus infection in women with rheumatic disease: cervical cancer screening and prevention. Rheumatology (Oxford) 57:v26-v33
Vinet, Evelyne; Chakravarty, Eliza F; Clowse, Megan E B (2018) Power in numbers. Rheumatology (Oxford) 57:v40-v47