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已发表论文
类风湿关节炎育龄患者孕前管理的最佳证据总结
Authors Liu S , Guo Y, Ren H, Zheng P, Lv T, Liu Q
Received 31 October 2025
Accepted for publication 18 December 2025
Published 24 December 2025 Volume 2025:18 Pages 8197—8208
DOI https://doi.org/10.2147/JMDH.S578181
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Veronica Swallow
Sanjiao Liu,1 Yifan Guo,1 Hua Ren,1 Pengyan Zheng,1 Ting Lv,2 Qingqing Liu2
1School of Nursing, Shanxi University of Chinese Medicine, Jinzhong City, Shanxi Province, 030619, People’s Republic of China; 2School of Nursing, Shanxi Medical University, Taiyuan City, Shanxi Province, 030001, People’s Republic of China
Correspondence: Hua Ren, School of Nursing, Shanxi University of Chinese Medicine, 121 University Street, Yuci District, Jinzhong City, Shanxi Province, 030619, People’s Republic of China, Email 13453135223@163.com
Background: The onset of rheumatoid arthritis (RA) most often occurs during the reproductive years. The chronic inflammatory state associated with the disease, along with the effects of therapeutic agents, contributes to a significantly higher incidence of adverse pregnancy outcomes compared to the general population. Standardized preconception management for childbearing-age patients with RA is an important prerequisite for achieving a safe pregnancy and promoting healthy offspring. However, existing evidence is scattered, and clinical practice lacks efficient evidence-based guidelines.
Objective: To identify, evaluate, and summarize the best available evidence on preconception care for childbearing age with RA, and to provide evidence-based guidance for clinical nursing practice.
Methods: A systematic search was conducted according to the “ 6S” pyramid model of evidence-based resources to identify evidence related to preconception management in childbearing-age patients with RA. Sources included clinical decision support systems, guidelines, databases, and professional association websites. The search covered all records from database inception until June 17, 2025.
Results: A total of 11 publications were included, comprising 3 guidelines, 5 expert consensuses, 2 clinical decisions, and 1 systematic review. From these sources, a comprehensive set of 23 best evidence recommendations was formed across seven key aspects: general principles, fertility risk assessment, preconception screening, pre-pregnancy medication adjustment, fertility preservation, weight and nutrition management, and psychological support. Among the evidence gathered, a strong recommendation was made for 15 items, while the remaining 8 received a weak recommendation.
Conclusion: This study provides a summary of best evidence for the preconception management of childbearing-age patients with RA, offering valuable guidance for clinical practice. To maximize patient benefits, healthcare providers should exercise careful clinical judgment when applying this evidence, taking into account the specific clinical context, individual patient circumstances, and preferences.
Trial Registration: ES20258177.
Keywords: rheumatoid arthritis, childbearing age, preconception management, fertility, evidence summary, evidence-based nursing
1School of Nursing, Shanxi University of Chinese Medicine, Jinzhong City, Shanxi Province, 030619, People’s Republic of China; 2School of Nursing, Shanxi Medical University, Taiyuan City, Shanxi Province, 030001, People’s Republic of China
Correspondence: Hua Ren, School of Nursing, Shanxi University of Chinese Medicine, 121 University Street, Yuci District, Jinzhong City, Shanxi Province, 030619, People’s Republic of China, Email 13453135223@163.com
Background: The onset of rheumatoid arthritis (RA) most often occurs during the reproductive years. The chronic inflammatory state associated with the disease, along with the effects of therapeutic agents, contributes to a significantly higher incidence of adverse pregnancy outcomes compared to the general population. Standardized preconception management for childbearing-age patients with RA is an important prerequisite for achieving a safe pregnancy and promoting healthy offspring. However, existing evidence is scattered, and clinical practice lacks efficient evidence-based guidelines.
Objective: To identify, evaluate, and summarize the best available evidence on preconception care for childbearing age with RA, and to provide evidence-based guidance for clinical nursing practice.
Methods: A systematic search was conducted according to the “ 6S” pyramid model of evidence-based resources to identify evidence related to preconception management in childbearing-age patients with RA. Sources included clinical decision support systems, guidelines, databases, and professional association websites. The search covered all records from database inception until June 17, 2025.
Results: A total of 11 publications were included, comprising 3 guidelines, 5 expert consensuses, 2 clinical decisions, and 1 systematic review. From these sources, a comprehensive set of 23 best evidence recommendations was formed across seven key aspects: general principles, fertility risk assessment, preconception screening, pre-pregnancy medication adjustment, fertility preservation, weight and nutrition management, and psychological support. Among the evidence gathered, a strong recommendation was made for 15 items, while the remaining 8 received a weak recommendation.
Conclusion: This study provides a summary of best evidence for the preconception management of childbearing-age patients with RA, offering valuable guidance for clinical practice. To maximize patient benefits, healthcare providers should exercise careful clinical judgment when applying this evidence, taking into account the specific clinical context, individual patient circumstances, and preferences.
Trial Registration: ES20258177.
Keywords: rheumatoid arthritis, childbearing age, preconception management, fertility, evidence summary, evidence-based nursing