PREGNANCY IN INFLAMMATORY RHEUMATIC DISEASES: PATIENT AND HEALTH PROFESSIONAL PERSPECTIVES

Central Asian Journal of Medical Hypotheses and Ethics, 2026

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DOI 10.47316/cajmhe.2026.7.2.05
Data confidence 85 high
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Abstract

Inflammatory rheumatic diseases disproportionately affect women of reproductive age and pose challenges from preconception to delivery. Although patient and specialist awareness in the field is growing, the evidence base for pregnancy management in this population is primarily based on observational studies and expert opinion. Ethical issues limit the availability of high-quality randomized controlled trials. This article presents a multidisciplinary framework that integrates patient, obstetric, and rheumatological perspectives, along with recent advances in artificial intelligence. From the patient perspective, voluntary childlessness due to concerns about medication safety, inadequate counseling, and psychosocial stressors remains a big public health issue. The obstetric perspective emphasizes increased risks of preeclampsia, preterm birth, intrauterine growth restriction, and postpartum disease flare, highlighting the necessity for structured high-risk monitoring and coordinated multidisciplinary care. The rheumatologist’s responsibilities include monitoring disease activity, discontinuing teratogenic medications, assessing ovarian reserve, screening for infections, planning rehabilitation, and managing comorbidities before conception. Artificial intelligence and machine learning technologies hold promise for risk stratification, early warning systems, and patient education, though challenges such as algorithmic bias and data limitations persist. International surveys are warranted to identify patient and specialist knowledge gaps, practice variations, and patient experiences across different health systems and cultural settings. Special consideration is warranted for Central Asia and the Turkic world, where structural barriers to specialist care, cultural expectations regarding childbearing, and limited regional research output contribute to a unique and underserved public health environment. This article provides guidance for health professionals and as a foundation for future research, promoting individualized, evidence-based, and culturally sensitive care for women with inflammatory rheumatic diseases throughout pregnancy.