Two cases of pregnancy and childbirth in juvenile idiopathic arthritis patients.

Abstract

We　herein　report　two cases　comprising　three　pregnancies　associated　with　juvenile　idiopathic　arthritis（JIA）、　 The　first　patient　was　a　31-year-old　female　with　rheumatoid　factor（RF）-positive　poly-JIA　and　systemic lupus　erythematosus．　She　wished　to　conceive　at　27　years　of　age　after　undergoing　successfull　treatment　with methotrexate　and　infliximab．　She　became　pregnant　after　the　discontinuation　of　these　drugs；however，the arthritis　flared　up．　At　gestational　week（GA）34、　she　delivered　a　baby　weighing　982g　via　Caesarean　section　due to　severe　intrauterine　growth　restriction.　She　subsequently　conceived　a　second　child　under　conditions　of　a moderate　disease　activity　despite　the　administration　of　etanercept．　At　GA　25，　she　delivered　a　baby　weighing 592g via　emergent　Caesarean　section　due　to　preeclampsia，　The　second　patient　was　an　l6-year-old　female　with RF　positive　poly-JIA．　ADA　was　discontinued　without　any　flare-ups　when　unexpected　pregnancy　was　identified． At　GA　37，she　gave　birth　to　a　child　weighing　2,932g． 　　　Based　on　our　experience，　we　believe　that　patients　with　JIA　who　are　considering　pregnancy　or　who　become pregnant　should　achieve　good　control　of　their　disease　activity　with　an　appropriate　form　of　effective　treatment， Intensive　obstetric　care　is　also　required　throughout　pregnancy．　Furthermore，　Pediatric　rheumatologists　should be　careful　to　check　for　not　only　psychological, but　also　sexual　issues，in　adolescent　JIA　patients．