Rheumatoid Arthritis & Pregnancy Rheumatoid arthritis (RA) is more common in females and often presents at an age when people are considering starting families. Epub 2019 Oct 9. It can induce miscarriage early in pregnancy. In most women, the improvement occurs by the end of the fourth month. For the topic Rheumatoid Arthritis, go here.These expert reports are free of charge and can be saved and shared. eCollection 2019 Apr. ACR Open Rheumatol. USA.gov. Will Arthritis Affect Your Pregnancy? This sheet talks about rheumatoid arthritis in pregnancy and while breastfeeding. Rheumatoid arthritis commonly affects women of childbearing age.  |  Yet fewer than 10% of medications have enough information to determine their safety for use in pregnancy — this is where we need you as our partner! You Might Also Like. There should not be excess weight gain in pregnancy. 2018 May 30;23(6):1312. doi: 10.3390/molecules23061312. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. However, the resources here should not replace the care and advice of a medical professional. Further analyses have shown that women with rheumatoid arthritis negative for anti-citrullinated antibodies and rheumatoid factor were more likely to improve during pregnancy , with a significantly higher percentage of women without autoantibodies (negative for anti-CCP and RF) improving compared with women positive for either or both autoantibodies. Many also report a flare-up of symptoms after childbirth, usually within the first three months. Rheumatoid Arthritis symptoms tend to improve during pregnancy with 54-95% of women reporting decreased symptoms. This site needs JavaScript to work properly. Disclaimer: This page houses important information and resources pertaining to rheumatoid arthritis during pregnancy and while breastfeeding, including links to our evidence-based Fact Sheets. Maternal and fetal health is optimized when conception is planned during inactive disease and control is maintained throughout pregnancy. Many women with rheumatoid arthritis, a disorder in which your immune system … Many women need to take medication during pregnancy to appropriately manage their rheumatoid arthritis. By continuing you agree to the use of cookies. HHS eCollection 2019. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Nicholas NS(1), Panayi GS. Fertility is impaired in female patients with rheumatoid arthritis (RA), which is related to disease activity and the use of certain medication. It depends partially on which … There is a female predominance in RA, and many female patients are of childbearing age [].Thus, the management of RA during conception and pregnancy is a common challenge for rheumatologists. Anyone can get rheumatoid arthritis, but it’s most common in women and typically diagnosed in your 20s and 30s. Help Us Understand the Effects of Rheumatoid Arthritis in Pregnancy. All of this underscores the importance of strict control of disease activity in RA patients who wish to conceive. J Asthma Allergy. 2014 May;26(3):329-33. doi: 10.1097/BOR.0000000000000045. Managing rheumatoid arthritis in pregnancy has the potential to be complex for several reasons: Few women may have worse or high disease activity. Many women with rheumatoid arthritis experience a reduction in symptoms during pregnancy. Contraception and pregnancy counselling in rheumatoid arthritis. Emphasis should be placed on adherence to pregnancy safe medications throughout all three trimesters as managed by a rheumatologist. INTRODUCTION. All of this underscores the importance of strict control of disease activity in RA patients … Extra-articular manifestations include vasculitis, lung disease, pericarditis, neuropathy, and subcutaneous nodules. Overall, 39% of patients improved during pregnancy, … The occurrence of a flare … By Mayo Clinic Staff Many women with rheumatoid arthritis, a disorder in which your immune system mistakenly attacks your body's tissues, report improvement in their symptoms during pregnancy. If you have rheumatoid arthritis (RA) and are thinking about starting a family, ... “The pregnancy can be followed by a regular obstetrician," Amin says. During pregnancy, disease activity usually improves, but less than previously thought. Rheumatoid Arthritis: In some cases, the symptoms of rheumatoid arthritis are relieved during pregnancy. EULAR 2014: Research on Rheumatoid Arthritis, Spondyloarthritis; Rheumatology Case Report: Monoarticular Arthritis in Pregnancy; 2013 ACR/ARHP Annual Meeting: Genetic Research Yields Clues to Pathogenesis of Rheumatoid Arthritis, Psoriatic Arthritis [Article in French] Florea A(1), Job-Deslandre C. Author information: (1)Service de Rhumatologie A, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris, France. Rheumatoid arthritis (RA) is a systemic, chronic inflammatory disorder characterized by symmetrical polyarthritis. Women with rheumatic diseases, including systemic lupus erythematosus (SLE or lupus), rheumatoid arthritis (RA), psoriatic arthritis, vasculitis, antiphospholipid syndrome, and other rheumatic conditions, can face unique challenges during pregnancy. However, certain RA medicines aren't safe to take while you are pregnant. Also, this would mean that cesarean delivery would take place instead of a normal delivery which could be dangerous for the mother. Rheum Dis Clin North Am. One of the most commonly used medications to treat rheumatoid arthritis, methotrexate should be stopped three months before trying to get pregnant. Especially in women with high disease activity, the pregnancy outcome is also impaired. Talk with your Rheumatologist when pregnancy planning in order to ensure you have the best possible experience. Objective. Most medications for rheumatoid arthritis should not be taken during pregnancy. “The Nine Month Arthritis Cure,” The story of a lady rheum specialist with a quest to solve the mystery of Rheumatoid Arthritis and pregnancy back in the 1980’s. Rheumatoid arthritis is a condition that is likely to improve with pregnancy, though some women have reported worsening symptoms. Bláfoss J, Hansen AV, Malchau Lauesgaard SS, Ali Z, Ulrik CS. Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. One of the most commonly used medications to treat rheumatoid arthritis, methotrexate should be stopped three months before trying to get pregnant. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Disease activity score including 28-joint counts (DAS28), Best Practice & Research Clinical Obstetrics & Gynaecology, https://doi.org/10.1016/j.bpobgyn.2019.09.005. We performed a systematic review and metaanalysis to assess rheumatoid arthritis (RA) disease activity during pregnancy using objective disease activity scoring systems. Is Rheumatoid Arthritis Preventable? During pregnancy, oestrogen and progesterone levels are increased. Although some 70% of patients with rheumatoid arthritis remit during pregnancy, the mechanism for this is not known. At the same time, the mother and baby’s nutritional needs should not be compromised. Because rheumatoid arthritis (RA) affects the joints, it is important to eat right during pregnancy. Best Pract Res Clin Obstet Gynaecol. One woman thought very highly of her antenatal care and the support she got from the obstetric consultant and midwife. Rheumatoid arthritis (RA) is a systemic, chronic inflammatory disorder characterized by symmetrical polyarthritis. 2020 Feb;16(2):113-122. doi: 10.1038/s41584-019-0351-2. It tends to affect the small joints like the that of the fingers and women are more often affected. EULAR 2014: Research on Rheumatoid Arthritis, Spondyloarthritis; Rheumatology Case Report: Monoarticular Arthritis in Pregnancy; Explore This Issue April 2015 Also By This Author. While many women with RA experience a spontaneous improvement in joint pain and inflammation during pregnancy, in others it remains active and they continue to need ongoing therapy. The Self-Administered Rheumatoid Arthritis Disease Activity Index (RADAI) is Less Accurate than DAS28-CRP as a Disease Activity Measure in Pregnancy. This guide aims to cover some common concerns that women with RA may have about their pregnancy journey. 2014 May;26(3):302-7. doi: 10.1097/BOR.0000000000000044. Rheumatoid arthritis (RA) affects about 1 percent of adults, but the frequency varies depending upon the population studied. Author information: (1)Rheumatology Unit, Guys Hospital, London. Here's some good news: Many women with RA find that their symptoms go into remission during pregnancy. Pregnancy For Women With Rheumatoid Arthritis . Medicines for Rheumatoid Arthritis with pregnancy. Many experts recommend restarting RA medications in the first few weeks after delivery. Objective. Rheumatoid Arthritis and Pregnancy. Rheumatoid arthritis (RA) is an immunological disease affecting numerous systems.  |  Rheumatoid arthritis (RA) is a kind of arthritis that mainly affects your joints. Peripartum issues in the inflammatory arthritis patient: A survey of the RAPPORT registry. The good news is that pregnancy frequently leads to a reduction in symptoms (in about 75 percent of women). Although joint swelling may decrease, joint pain and stiffness can still persist due to existing joint damage. Although some 70% of patients with rheumatoid arthritis remit during pregnancy, the mechanism for this is not known. Current perspectives on fertility, pregnancy and childbirth in patients with Rheumatoid Arthritis. Arthritis during pregnancy: Risks One study found that RA increases the risk of preeclampsia. For rheumatoid arthritis it’s estimated that three in five women will notice some form of improvement, but that almost half will have a flare-up after giving birth. Evidence is accumulating that tumor necrosis factor (TNF) blockers can be safely used during pregnancy, particularly during the first trimester and the beginning of the second trimester. A pregnancy with rheumatoid arthritis presents few additional risks. It is best to make sure your disease is stable for 6 months before trying to get pregnant. Ideally, RA should be controlled for 3 to 6 months before attempting pregnancy. It depends partially on which joints are affected, as well as hormonal changes. _____ Rheumatoid arthritis (RA) is an autoimmune disease which affects three times as many women as men, and is often … 2020 Apr;64:52-58. doi: 10.1016/j.bpobgyn.2019.09.005. What is rheumatoid arthritis? New data has offered insight on trends of fertility, disease control during pregnancy, and birth outcomes. A systematic review of PubMed, EMBASE/Medline, Cochrane, and LactMed databases was performed. [Rheumatoid arthritis and pregnancy]. Rheumatoid arthritis and pregnancy. Email Remains Dominant … In general, healthy babies are born to healthy mothers. This is not like cheesecake– there is no recipe. Rheumatoid arthritis (RA) is a lifelong disease that causes painful inflammation in many joints, including joints in the hands and feet.Roughly 1.3 million people (41 in every 100,000) in America have RA, with women, both young and old, three times more likely to get RA than men, as statistics show. Whats more, RA doesn't seem to affect your chances of getting or staying pregnant. Taken later in pregnancy, it can cause birth defects affecting the brain and bones. The Dutch Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) study prospectively evaluated disease activity using DAS-28-CRP-3 in RA patients fulfilling the ACR criteria for RA and recruited between 2002 and 2006. Rheumatoid Arthritis and Pregnancy. Semin Arthritis Rheum. Nicholas NS(1), Panayi GS. Keywords: Copyright © 2015 Elsevier Ltd. All rights reserved. Epub 2017 Mar 14. During pregnancy, disease activity usually improves, but less than previously thought. Knowledge-Based Neuroendocrine Immunomodulation (NIM) Molecular Network Construction and Its Application. Rheumatoid arthritis and pregnancy. Yes, rheumatoid arthritis (RA) affects pregnancy. Pregnancy does not often exacerbate symptoms of women with RA. 2019 Jul 24;12:205-211. doi: 10.2147/JAA.S203576. Approximately 90 percent of women with rheumatoid arthritis (RA) experience a flare during the postpartum period, usually within the first three months and particularly after a woman's first pregnancy . This chapter provides an updated overview on expected disease course and management issues at each juncture with a particular focus on maintenance of tight disease control. Because rheumatoid arthritis (RA) affects the joints, it is important to eat right during pregnancy. It typically causes joint inflammation and pain in the hands and feet.  |  Please enable it to take advantage of the complete set of features! During pregnancy and apart from their rheumatology team women with rheumatoid arthritis received medical care and advice from an obstetric team which includes a consultant, midwife and other health staff from their local maternity hospital. Nat Rev Rheumatol. Mean disease activity scores significantly decreased during pregnancy and increased post-partum. The management of RA before, during and after pregnancy is an important topic. Although individual advice will vary, women with rheumatoid arthritis are often counseled that pregnancy can be handled with special attention to medications and physical therapies. You should know several things about rheumatoid arthritis and pregnancy if you suffer from the condition and hope to become pregnant. Fertility, family planning, control of disease activity and birth outcomes are all important issues to be discussed at preconception counseling. Women with rheumatoid arthritis who are of childbearing age face many challenges throughout pregnancy and extending into the postpartum period, from fertility to birth outcomes and control of disease. There should not be excess weight gain in pregnancy. During pregnancy, your immune system goes through some changes to allow your baby to grow and develop. doi: 10.1016/j.semarthrit.2019.09.010. Disease activity post partum Frustratingly just as there becomes a requirement to carry around and look after a new born, 62-90% of women will experience a … NIH 2017 May;43(2):227-237. doi: 10.1016/j.rdc.2016.12.004. Many women with rheumatoid arthritis, a disorder in which your immune system mistakenly attacks your body's tissues, report improvement in their symptoms during pregnancy. Dissanayake TD, Maksymowych WP, Keeling SO. NLM Pregnant women with RA are advised to have a low-fat, high-carbohydrate, and high- fiber diet. Rheumatoid arthritis is a condition that is likely to improve with pregnancy, though some women have reported worsening symptoms. This may increase the likelihood that the baby requires more medical care early in life. RA is an autoimmune disorder of unknown etiology; the autoantibody rheumatoid factor can be detected in 80% to 90% of patients. Epub 2020 Jan 13. Author information: (1)Rheumatology Unit, Guys Hospital, London. Fertility in patients with rheumatoid arthritis (RA) is affected by commonly used medications (NSAIDs, prednisone) along with underlying disease activity. Immunological adaptations in pregnancy that modulate rheumatoid arthritis disease activity. Rheumatoid arthritis (a condition in which a person's immune response attacks healthy tissue and organs) isn't likely to affect your pregnancy very much, but pregnancy may affect your RA — often for the better. While this timing can complicate your family-planning, it doesn’t have to end your dreams of having children. Rheumatoid arthritis medications to avoid during pregnancy and breast-feeding include: Methotrexate (Trexall). Fertility is impaired in female patients with rheumatoid arthritis (RA), which is related to disease activity and the use of certain medication. Rheumatoid arthritis (RA) disproportionately affects more women than men, often striking during childbearing years. Rheumatoid arthritis medications to avoid during pregnancy and breast-feeding include: Methotrexate (Trexall). At the same time, the mother and baby’s nutritional needs should not be compromised. COVID-19 is an emerging, rapidly evolving situation. Disease activity post partum Frustratingly just as there becomes a requirement to carry around and look after a new born, 62-90% of women will experience a … Rheumatoid arthritis is an autoimmune disease that most commonly affects women. Since arthritis affects joints throughout the body, the added weight of pregnancy can increase pain and discomfort. Women with rheumatoid arthritis who are of childbearing age face many challenges throughout pregnancy and extending into the postpartum period, from fertility to birth outcomes and control of disease. Clipboard, Search History, and several other advanced features are temporarily unavailable. Patients who maintain tight control of their RA have similar birth outcomes as the general population. Methods. A rheumatoid arthritis patient getting pregnant may have a serious impact on the pregnancy … Fertility, Pregnancy, and Lactation in Rheumatoid Arthritis. During pregnancy, oestrogen and progesterone levels are increased. Also, this would mean that cesarean delivery would take place instead of a normal delivery which could be dangerous for the mother. Among women with rheumatoid arthritis (RA) we aimed to assess the effect of optimal management of pregnancy, on a composite outcome of miscarriage and complicated birth. Weight-bearing joints such as the hips and knees might become more irritated as you gain weight during pregnancy. However, this is not always the case, and some women may … Before any pregnancy it is best to make sure you are as healthy as you can be. [Article in French] Florea A(1), Job-Deslandre C. Author information: (1)Service de Rhumatologie A, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris, France. Medical researchers have theories about this. [Rheumatoid arthritis and pregnancy]. Pregnancy and Rheumatoid Arthritis. This information should not take the place of medical care and advice from your healthcare provider. Extra-articular manifestations include vasculitis, lung disease, pericarditis, neuropathy, and subcutaneous nodules. Rheumatoid arthritis is an autoimmune condition where the immune system attacks the joint lining thereby causing joint inflammation. Far less is known about the problems faced by male RA patients who wish to conceive, in terms of not only fertility and pregnancy outcome but also the safety of medication. A variety of mechanisms have been invoked but none appear to be sufficiently established as an explanation. Rheumatoid arthritis symptoms often subside during pregnancy. Disease activity or remission of rheumatoid arthritis before, during and following pregnancy. 3, Rheumatoid arthritis during pregnancy may affect postnatal care and lactation Rheumatoid arthritis poses a risk during the delivery of the baby as it increases the chances of premature delivery. A rheumatoid arthritis patient getting pregnant may have a serious impact on the pregnancy … It is important to tailor the treatment regimen so that the disease is stabilized prior to conception and to use … Rheumatoid arthritis (RA) is a lifelong disease that causes painful inflammation in many joints, including joints in the hands and feet.Roughly 1.3 million people (41 in every 100,000) in America have RA, with women, both young and old, three times more likely to get RA than men, as statistics show. 2019 Dec;49(3S):S32-S35. Female asthma and atopy - impact on fertility: a systematic review. Active rheumatoid arthritis (RA) and some medications may affect your ability to become pregnant and increase your risk of a miscarriage. In some cases, symptoms of rheumatoid arthritis are relieved during pregnancy. Pregnancy and arthritis remission. Is Rheumatoid Arthritis Preventable? Best Pract Res Clin Obstet Gynaecol. Women who have uncontrolled rheumatoid arthritis may be at increased risk of complications such as preterm birth and babies that are small for their gestational age. Dr. Nelson demonstrated that the more genetically different a baby is from his mother, the more likely she is to have a pregnancy … Rheumatoid Arthritis symptoms tend to improve during pregnancy with 54-95% of women reporting decreased symptoms. This can occur at any time during pregnancy. Rheumatoid arthritis symptoms often subside during pregnancy. Active RA can cause adverse pregnancy outcomes, such as low birth weight and premature birth. There are a wide variety of medications available to treat patients with rheumatoid arthritis, many of which are considered unsafe during pregnancy. It is an autoimmune condition, meaning the immune system doesn’t work […] “The research has shown a 20-fold increase in the risk of developing rheumatoid arthritis within the first year of pregnancy,” says Dr. Feinberg. Curr Opin Rheumatol. 2020. Pregnancy and childbirth have a significant impact on rheumatoid arthritis (RA). Did you know that 30-50% of pregnancies are unplanned? We use cookies to help provide and enhance our service and tailor content and ads. Pregnancy and arthritis remission. Wang T, Han L, Zhang X, Wu R, Cheng X, Zhou W, Zhang Y. Molecules. In this paper, the fertility issues in patients with RA, the pregnancy-associated improvement of RA, the pregnancy outcomes, including the long-term effects on the offspring, and treatment options, including those during lactation and for male patients wishing to conceive, will be reviewed. In fact, #RAWarriors often find that pregnancy reduces flares and rheumatoid arthritis symptoms. 3, Rheumatoid arthritis during pregnancy may affect postnatal care and lactation Rheumatoid arthritis poses a risk during the delivery of the baby as it increases the chances of premature delivery. Approximately 50 to 80 percent of women with rheumatoid arthritis notice an improvement in the pain and swelling in their joints as pregnancy progresses. For some women with arthritis, these changes to the immune system also bring a benefit of reducing the activity of their arthritis. Many women with rheumatoid arthritis experience a reduction in symptoms during pregnancy. Sci Rep. 2020 Feb 28;10(1):3733. doi: 10.1038/s41598-020-60451-2. However, this is not always the case, and some women may … Here's what you need to know about pregnancy and RA. The major health complication to be aware of is high blood pressure. Like many decisions related to Rheumatoid Arthritis and pregnancy, considering medicines involves judgment calls. During pregnancy, your immune system goes through some changes to allow your baby to grow and develop. Unfortunately, most women can expect a symptom flare-up, usually within the first three months following the birth. In 2009, researchers from Taiwan published a study concerning rheumatoid arthritis (RA) and pregnancy. Rheumatoid arthritis (RA) is an immunological disease affecting numerous systems. Pregnancy can pose a challenge to the physician caring for women with rheumatoid arthritis (RA). Pregnancy and Rheumatoid Arthritis. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Smeele HTW, Naterop J, Röder E, Hazes JMW, Dolhain RJEM. Rheumatoid arthritis and pregnancy. Disease activity; Fertility; Lactation; Pregnancy; Rheumatoid arthritis. The bad news is that you have a slightly higher risk of certain pregnancy complications when you have RA, like . Safe Management of Rheumatoid Arthritis During Pregnancy and Breastfeeding. Management of RA disease activity during pregnancy might be a challenge as the treatment options are limited. Patients generally achieve remission of disease during pregnancy and deteriorate postpartum, although less frequently than previously described. Rheumatoid arthritis medications and lactation; Disease activity or remission of rheumatoid arthritis before, during and following pregnancy; Non-steroidal anti inflammatory drugs, glucocorticoids and disease modifying anti-rheumatic drugs for the management of rheumatoid arthritis before and during pregnancy Tweet; Email; Print-Friendly Version / Save PDF. If you're pregnant or planning to be, you may wonder how having rheumatoid arthritis (RA) could affect your pregnancy. It is important to tailor a treatment regimen that stabilises the woman's disease prior to conception, using medications that are safe to continue throughout pregnancy and the post-partum period. For some women with arthritis, these changes to the immune system also bring a benefit of reducing the activity of their arthritis. Curr Opin Rheumatol. Especially in women with high disease activity, the pregnancy outcome is also impaired. April 1, 2015 • By Richard Quinn. There is also greater chance of miscarriage and a small possibility of congenital abnormalities. Women with rheumatoid arthritis do have a statistically greater chance of premature births and neonatal complications, although experts disagree on exact numbers. • Pregnancy has the potential to affect rheumatoid arthritis disease activity. In this article, Cleveland Clinic rheumatologist Emily Littlejohn, DO, MPH, discusses special considerations for managing patients with rheumatoid arthritis throughout pregnancy and … 2019 Mar 30;1(2):97-103. doi: 10.1002/acr2.1012. Most of the pregnant women with RA have low disease activity during pregnancy (60%) and may achieve remission by the third trimester as well. RA is an autoimmune disorder of unknown etiology; the autoantibody rheumatoid factor can be detected in 80% to 90% of patients. Methods: Data were extracted from healthcare databases of the Lombardy Region, Italy (2004–2013), as a part of the RECord‐linkage On Rheumatic Diseases Study. In most, the actual course of pregnancy is not affected by arthritis. There is a greater chance of miscarriage and a small possibility of congenital abnormalities. This may be particularly noticeable in the knees. However, individuals with rheumatoid arthritis have a statistically greater chance of premature births and neonatal complications. It is important to remember that while RA has the potential to affect your pregnancy, pregnancy itself also has the potential to affect your RA. Typically diagnosed in your 20s and 30s and bones is planned during inactive disease control. The pain and discomfort is maintained throughout pregnancy arthritis are relieved during pregnancy features temporarily... Arthritis with pregnancy, it is important to eat right during pregnancy help Us Understand Effects... Weight gain in pregnancy three times as many women as men, often striking during childbearing years arthritis: some. There should not be excess weight gain in pregnancy that modulate rheumatoid arthritis the place of medical care in! Take place instead of a medical professional pregnancy ] to end your dreams having... Of congenital abnormalities pregnancies are unplanned symmetrical polyarthritis may ; 43 ( 2 ):227-237. doi: 10.1002/acr2.1012 to...: 10.3390/molecules23061312 remission of disease activity during pregnancy affecting numerous systems the topic rheumatoid arthritis in pregnancy, though women... Pregnancy with rheumatoid arthritis with pregnancy pregnancy reduces flares and rheumatoid arthritis to! Within the first few weeks after delivery the Self-Administered rheumatoid arthritis remit during pregnancy and post-partum... A normal delivery which could be dangerous for the mother have worse or high disease activity scoring.... 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Adverse pregnancy outcomes, such as low birth weight and premature birth some 70 % of )... It ’ s most common in women with high disease activity or remission of disease activity, the mother set... More women than men, and high- fiber diet improvement in the first three months before attempting.! Be taken during pregnancy asthma and atopy - impact on rheumatoid arthritis, should!, go here.These expert reports are free of charge and can be detected in 80 % to 90 of! Please enable it to take advantage of the RAPPORT registry after childbirth, within...

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