Rheumatic and other immune-mediated diseases impact reproductive health and pregnancy outcomes, according to a recent study published by Kerola et al in Rheumatology. Investigators used data from Finnish nationwide health registers to analyze reproductive health measures—including reproductive success as well as adverse maternal and antenatal outcomes among 5.3 million patients born between 1964 and 1984. Patients included in the study had been diagnosed with any of 19 immune-mediated diseases prior to the age of 30 in women and 35 in men. The patients were matched with 20 controls based on birth year, sex, and education. Patients with systemic lupus erythematosus, juvenile idiopathic arthritis, and seropositive rheumatoid arthritis were more likely to experience childlessness and give birth to fewer children. The risks for preeclampsia, preterm delivery, nonelective cesarean section were also heightened in the patients with immune-mediated diseases, and their newborns were more likely to be small for their gestational age and need neonatal intensive care. These adverse maternal and antenatal outcomes were over twofold higher among those with lupus, Sjögren’s syndrome, type 1 diabetes, and Addison’s disease. The study authors concluded: “Despite seeing an elevated risk for diverse childbearing problems in [patients with] rheumatic and other immune-mediated diseases, many of the complications are still fairly rare. Family planning should actively be discussed between patients … with rheumatic diseases and their health-care providers.”