Many women with RA are facing pregnancy and childbirth plans during the treatment of their disease, but the effects of anti-rheumatic drugs on pregnancy are constantly troubling every RA patient, such as when to get pregnant, which medications will have an effect on the fetus, and which drugs can be used for changes in RA pregnancy. Perhaps the following suggestions will be useful and helpful for RA patients who intend to get pregnant. I. Drugs that should be stopped before pregnancy 1. Methotrexate: stop using it in the first three months of pregnancy and prohibit it during pregnancy. After stopping methotrexate, at least wait for the next period to consider pregnancy, and folic acid supplementation is recommended before and during pregnancy. Quhuan Ru, Rheumatology Department, Shanghai Longhua Hospital 2. Leflunomide: Discontinue 2 years before planned pregnancy. Before planned pregnancy or unplanned pregnancy during treatment, rapid cleansing of the active metabolites of leflunomide with abciximide. 3. Rituximab (melphalan): a human-mouse chimeric monoclonal antibody targeting CD20 antigen expressed on mature B cells and B cell precursors. Discontinue use 1 year prior to planned pregnancy. 4.Abatacept (Abatacept): a selective T-cell costimulatory regulator that blocks key signals of the T-cell activation costimulatory pathway to inhibit and reverse the inflammatory process. Discontinue it 10 weeks before planned pregnancy. Second, the drugs should be discontinued at the time of pregnancy 1, anti-TNF biological agents (class gram, Ixepro, adalimumab): it is not clear whether TNF antagonist treatment has long-term effects on the fetus, once it is determined to have been pregnant, immediately discontinue. 2. Bisphosphonates (Fosamax, Gupta, etc.): Intravenous bisphosphonates can cause fetal hypocalcemia and should be used with caution during pregnancy. Because of no follow-up results on long-term effects on infants, any type of bisphosphonates should be discontinued once pregnancy is established. Drugs available in pregnancy 1. Chloroquine phosphate and hydroxychloroquine: they are safe for the fetus. Since more cases of hydroxychloroquine than chloroquine phosphate have been observed during pregnancy, and the concentration in maternal tissues is lower in the former than in the latter, it is better to take hydroxychloroquine than chloroquine phosphate during pregnancy. 2.Lyuzosulfapyridine: it can be used during pregnancy, but it needs to be supplemented with folic acid. 3. Azathioprine: It can be used during pregnancy, but the dose should be less than 2mg/kg, d. If the dose is high, there is a risk of fetal erythropoiesis suppression. 4.Cyclosporine A: 2,5-5,0mg/kg,d dose of cyclosporine can be taken during pregnancy. 5.Hormone: oral prednisone or intra-articular injection of hormone can be taken. However, the minimum dose should be used during the first 3 months of pregnancy (to avoid increasing the risk of orofacial fracture). Long-term hormone users need to increase the dose appropriately in the perinatal period. 6.Non-steroidal anti-inflammatory drugs: drugs with a short half-life such as lexapro are preferred during the first 32 weeks of pregnancy. After 7 months of pregnancy, the use of such drugs should be stopped. It is best to intermittently take the lowest effective dose of NSAIDs to reduce the risk of adverse fetal reactions. IV. Treatment options for exacerbations in pregnancy Acute arthritis attacks during pregnancy can occur in 10-25% of patients. More than one arthritis: intra-articular hormone injection and oral NSAIDs (including fotarine, ibuprofen, naproxen, etc.) can be used, and it should be noted that they should be stopped at 32 weeks of pregnancy. 2.Only joint pain: paracetamol can be used, 1-4g/day is a safe dose. 3, systemic symptoms: oral small doses of hormones, while adjusting second-line drug therapy.