Lisa Malter, MD, on Pregnancy and Autoimmune Conditions

In this video, Lisa Malter, MD, discusses some key points from her IAS presentation on "Pregnancy and Autoimmune Disorders: Optimizing Outcomes for Mother and Baby." 

Lisa B. Malter, MD, is a gastroenterologist and an associate professor of medicine in the Department of Medicine, Division of Gastroenterology at NYU Grossman School of Medicine. 

Transcript:

Dr. Lisa Malter: My name is Lisa Malter, and I'm an Associate Professor of Medicine in the Division of Gastroenterology at the NYU Grossman School of Medicine. During the IAS meeting, I spoke about pregnancy and autoimmune conditions.

This is super important, because as we know, many autoimmune conditions impact a greater percentage of women compared to men, and oftentimes onset at younger ages and coincide with the child-bearing years.

Having an awareness of how to optimally manage patients during this period of time is really important for both the baby and the mother's outcome. It's important to be aware of preconception counseling for patients, because we really want to have our patients' autoimmune diseases under control as much as possible before they go into a pregnancy.

It helps ensure the best outcome for both the baby and the mother, and so sometimes, this means a course of contraception while getting the disease under control. We also want to be very cognizant of the patient's medication regimen as they go into pregnancy, and make sure that the medications are considered safe.

We have a really nice guideline that's put out by the American College of OB and Gynecology and the Society for Maternal Fetal Medicine that helps us understand which medications are safe. Thankfully, the majority of our medications are safe to continue during pregnancy.

We also want to pay attention to the patient during the entire pregnancy, seeing them at least once a trimester, in order to check in on how they're doing, with an awareness that some of the physiologic changes that occur related to pregnancy may impact labs that we send on our patients and symptoms that the patients report.

Lastly, we want to pay attention to our patients in the postpartum setting, because there are certain circumstances that can occur around the time of delivery or in the immediate postpartum settings, with things like an increased risk of thrombotic events, questions pertaining to lactation, questions pertaining to pain management with regard to delivery.

We want to make sure that we can optimize the care for our patients, because there are recommendations for how to do so. We also want to emphasis the need of the multidisciplinary team to help ensure the best outcome for the patient.

This includes the obstetrician. This includes the autoimmune disease specialist. In some cases, it may include the colorectal surgeons. The benefit of a nutritionist and a psychologist can be really instrumental as well.

Working together with that entire team is going to help, really, again ensure the best outcome for both the baby and the mother. We can really do a lot for our patients in order to optimize the outcomes, and a great knowledge of the resources and tools that are out there to help patients during this fragile and exciting moment in their life is really critical.

Thank you for your time today.