Rheumatoid Arthritis and Pregnancy: What You Need to Know
Is RA safe for your baby?
I’m Pregnant—Will My RA Cause Problems?
In 2010, researchers from Taiwan published a study concerning rheumatoid arthritis (RA) and pregnancy. The reviewed data from the Taiwan National Health Insurance Research Database found that women with RA had an increased risk of giving birth to a child with low birth weight, or who were small for gestational age.
Women with RA were also at greater risk for preeclampsia (high blood pressure), and were more likely to go through a cesarean section delivery.
What other risks are present for women with RA? How do they affect family planning? Read on to find out.
Can I Have Children?
According to the Centers for Disease Control and Prevention (CDC), more women then men are diagnosed with rheumatoid arthritis. That means many women have to face the possibility that RA may affect their pregnancies.
The American College of Rheumatology notes that for years, women with autoimmune diseases like RA were advised not to get pregnant. That’s no longer the case. Today, with careful medical care, women with RA can fully expect to have successful pregnancies and deliver healthy babies.
It May Be Harder to Get Pregnant
In a 2011 study of 68,000 pregnant women, those with RA had a harder time conceiving than those without the disease. A total of 25 percent of women with RA had tried for at least a year before they became pregnant. Only 16 percent of women without RA had to try that long before becoming pregnant.
Researchers aren’t sure if it’s RA itself, or the medications used to treat it, that may cause the difficulty. Either way, only a quarter of women had trouble conceiving. You may not. If you do, check with your doctor, and don’t give up.
Your RA May Ease Up
Women with RA may experience remission during pregnancy. A 1999 study of 140 women found that 63 percent reported symptom improvement at the third trimester. A 2008 study found that patients felt better during pregnancy, but experienced flare-ups after delivery.
This may or may not happen to you. If it does, enjoy the reduced symptoms, but ask your doctor how to prepare for possible flare-ups after the baby is born.
Your Pregnancy May Trigger RA
Pregnancy floods the body with a number of hormones and chemicals, which can trigger the development of RA in some women. Women who are susceptible to the disease may experience it for the first time immediately after giving birth.
A 2011 study examined records of more than one million women born between 1962 and 1992. About 25,000 developed autoimmune diseases like RA. Women had a 15 to 30 percent greater risk of contracting these types of disorders in the first year after delivery.
Risk of Preeclampsia
The Mayo Clinic notes that women with RA and other autoimmune diseases have a higher risk of preeclampsia. And the study from Taiwan also indicated that women with RA have an increased risk of the disorder.
Preeclampsia causes high blood pressure during pregnancy. Complications include seizures, kidney problems, and in rare cases, death of the mother and/or child. It typically starts after the 20th week of pregnancy, and can exist without any noticeable symptoms. It’s often discovered during prenatal checkups.
Though there is no “cure,” doctors provide increased monitoring to be sure mother and baby remain healthy.
Risk of Premature Delivery
Women with RA may have a higher risk of premature delivery. In a study published in 2013, researchers at Stanford University looked at all pregnancies complicated by RA between June 2001 and June 2009. A total of 60 percent of the women delivered prior to 37 weeks gestation (prematurely).
An earlier 2011 study also noted that women with RA have a higher risk of delivering smaller and preterm babies.
Risk of Low Birth Weight
Women who experience symptoms of RA during pregnancy may be at higher risk for delivering babies that are underweight.
A 2009 study looked at women with RA who became pregnant, and then looked at the outcomes. Results showed that women with well-controlled RA were not at greater risk for giving birth to small babies.
Those who suffered more symptoms during pregnancy, though, were more likely to have children who were considered to be at low birth weight.
Medications May Increase Risks
Some studies indicate that medications used to treat RA may increase risk of pregnancy complications. A 2011 study noted that disease-modifying antirheumatic drugs (DMARDs) in particular can be toxic to an unborn child. The number of studies in this area is limited, though.
A 2006 study reported that the availability of safety information regarding many RA medications is minimal. Talk to your doctor about the medications you’re taking to determine the benefits compared to the risks.
Your Family Planning
There are some risks to pregnant women with RA, but they’re low. They shouldn’t stop you from planning to have children. The important thing is to get regular checkups.
Ask your doctor about any potential side effects of the medications you’re taking. With careful prenatal care, you should be able to have a successful and healthy pregnancy and delivery.