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The management of rheumatoid arthritis (RA) during the peri-conceptional period necessitates consideration of maternal disease control and its impact on fetal growth, as well as the administration of vaccinations to both mothers and infants. Currently, only tumor necrosis factor-α (TNF-α) inhibitors possess adequate empirical evidence supporting their safety during preconception and lactation periods. Discontinuation of Fc structural domain-containing TNF-α inhibitors is required in the third trimester, only certolizumab pegol stands out as a viable option throughout pregnancy. The available research data on other biological agents for RA remains insufficient to establish their safety in pregnancy. The impact of biological agents on vaccination and vaccine response, especially for live attenuated vaccines, should be considered in both mothers and infants.

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类风湿关节炎（RA）患者围妊娠期的治疗需兼顾母亲病情的控制和对胎儿生长发育及母婴疫苗接种的影响。目前治疗RA的生物制剂仅肿瘤坏死因子-α（TNF-α）抑制剂有充足数据表明可在备孕期和哺乳期使用，妊娠晚期需停用含Fc结构域的TNF-α抑制剂，仅培塞利珠单抗可在整个妊娠期使用。其他种类的生物制剂研究数据尚不足以证明其妊娠期安全性。生物制剂母婴暴露需考虑对疫苗接种和疫苗应答的影响，尤其是会影响减毒活疫苗的接种。

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欧阳志明，男，住院医师，医学硕士，主要从事风湿病学诊治与研究。E-mail: ouyzhm3@mail.sysu.edu.cn。

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欧阳志明，男，住院医师，医学硕士，主要从事风湿病学诊治与研究。E-mail: ouyzhm3@mail.sysu.edu.cn。

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