Women of childbearing age are at risk for developing systemic rheumatic 
diseases. Pregnancy can be challenging to manage in patients with rheumatic 
diseases for a variety of reasons including the impact of physiological and 
immunological changes of pregnancy on underlying disease activity, the varied 
presentation of rheumatic disease during pregnancy, and the limited treatment 
options. Previously, patients with rheumatic disease were often advised against 
pregnancy due to concerns of increased maternal and fetal morbidity and 
mortality. However, recent advancements in the understanding of the interaction 
between pregnancy and rheumatic disease have changed how we counsel patients. 
Patients with rheumatic disease can have successful pregnancy outcomes, 
particularly when a collaborative approach between the rheumatologist and 
obstetrician is applied. This review aims to discuss the effect of pregnancy on 
patients with the most common rheumatic diseases, the effect of these diseases 
on the pregnancy itself, and the management of these patients during pregnancy.