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State of the Art: Fertilität und Schwangerschaft bei rheumatischen Erkrankungen

State of the art: fertility and pregnancy in rheumatic diseases


Entzündlich rheumatische Erkrankungen betreffen häufig Frauen im gebärfähigen Alter, für die eine Schwangerschaft nach wie vor mit erhöhten Risiken einhergeht. Gleichzeitig gewinnen wir immer mehr Einblick in Risikofaktoren und Präventionsmöglichkeiten, sodass für die meisten Frauen erfolgreiche und komplikationsarme Schwangerschaften möglich sind. Grundpfeiler sind eine Planung der Schwangerschaft unter guter Krankheitskontrolle und die Modifikation von behandelbaren Risikofaktoren. Dabei rückt erneut Hydroxychloroquin als Substanz mit vielfältigen positiven Wirkungen in den Fokus. Vom American College of Rheumatology (ACR) publizierte Empfehlungen geben einen praxisnahen Überblick zur Evidenzlage. Rheumatologen können, basierend auf dem aktuellen Wissensstand, nachhaltig zu einem positiven Schwangerschaftsverlauf für Mutter und Kind beitragen.


Inflammatory rheumatic diseases often affect women of childbearing age, for whom pregnancy is still associated with increased risks. At the same time, we are gaining more and more insights into risk factors and preventive strategies, enabling almost all women to have successful pregnancies with few adverse outcomes. The cornerstones are planning of the pregnancy under effective disease control and the modification of individual risk factors. Hydroxychloroquine is once again coming into focus as a compound with multiple positive effects. Recommendations published by the American College of Rheumatology (ACR) provide a practical overview of the evidence. Based on the current state of knowledge, rheumatologists can make a lasting contribution to a positive pregnancy outcome for mother and child.

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Correspondence to Isabell Haase.

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I. Haase und R. Fischer-Betz geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Rebecca Fischer-Betz, Düsseldorf

Frauke Förger, Bern

Anja Strangfeld, Berlin

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Haase, I., Fischer-Betz, R. State of the Art: Fertilität und Schwangerschaft bei rheumatischen Erkrankungen. Z Rheumatol 80, 699–706 (2021).

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  • Rheumatoide Arthritis
  • Systemischer Lupus erythematodes
  • Spondyloarthritis
  • Schwangerschaftskomplikationen
  • Schwangerschaftsplanung


  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Spondylarthritis
  • Pregnancy complications
  • Pregnancy counselling