I’m pregnant — will my RA cause problems?

In 2009, researchers from Taiwan published a study concerning rheumatoid arthritis (RA) and pregnancy. The data from the Taiwan National Health Insurance Research Dataset showed that women with RA had an increased risk of giving birth to a child with low birth weight or who was small for gestational age (called SGA).

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.

According to the Centers for Disease Control and Prevention (CDC), RA is more common among women than men.

The American College of Rheumatology notes that for years, women with autoimmune diseases like RA were advised to not get pregnant. That’s no longer the case. Today, with careful medical care, women with RA can expect to have successful pregnancies and deliver healthy babies.

In a 2011 study of over 74,000 pregnant women, those with RA had a harder time conceiving than those without the disease. Twenty-five percent of women with RA had tried for at least a year before they became pregnant. Only about 16 percent of women without RA tried that long before becoming pregnant.

Researchers aren’t sure if it’s RA itself, the medications used to treat it, or general inflammation that causes the difficulty. Either way, only one-quarter of women had trouble conceiving. You may not. If you do, check with your doctors, and don’t give up.

Women with RA usually go into remission during pregnancy. In a 1999 study of 140 women, 63 percent reported symptom improvement at the third trimester. A 2008 study found that women with RA felt better during pregnancy, but could experience flare-ups after delivery.

This may or may not happen to you. If it does, ask your doctor how to prepare for possible flare-ups after your baby is born.

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 1 million women born between 1962 and 1992. About 25,500 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.

The Mayo Clinic notes that women who have problems with their immune system have a higher risk of preeclampsia. And the study from Taiwan also indicated that women with RA have an increased risk of this condition.

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 20 weeks of pregnancy and can be present without any noticeable symptoms. It’s usually discovered during prenatal checkups.

When it is discovered, doctors provide increased monitoring and treat when needed to be sure mother and baby remain healthy. The recommended treatment for preeclampsia is delivery of the baby and placenta to prevent the disease from progressing. Your doctor will discuss the risks and benefits regarding timing of 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 28 percent of the women delivered prior to 37 weeks’ gestation, which is premature.

An earlier 2011 study also noted that women with RA have a higher risk of delivering SGA and preterm babies.

Women who experience symptoms of RA during pregnancy may be at higher risk for delivering underweight babies.

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 smaller babies.

Those who suffered more symptoms during pregnancy, however, were more likely to have children with low birth weight.

Some studies indicate that RA medications may increase risk of pregnancy complications. A 2011 study noted that certain disease-modifying antirheumatic drugs (DMARDs) in particular can be toxic to an unborn child.

A 2006 study reported that the availability of safety information regarding many RA medications and the reproductive risks is limited. Talk to your doctors about the medications you’re taking and the benefits compared to the risks.

There are some risks for pregnant women with RA, but 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.