Pregnancy and Rheumatoid Arthritis: Essential Information You Should Be Aware Of
Rheumatoid arthritis (RA), a common autoimmune disease, can impact pregnancy and vice versa. A 2023 review and meta-analysis suggests that RA may increase the risk of preeclampsia, a condition causing high blood pressure during pregnancy. Preeclampsia can lead to complications such as seizures and kidney problems. When preeclampsia is discovered, doctors increase monitoring and treat when needed to ensure the mother and baby remain healthy. It typically starts after 20 weeks of pregnancy and can be present without noticeable symptoms. The recommended treatment is delivery of the baby and placenta to prevent the disease from progressing.
RA may also increase the risk of delivering babies preterm or small for gestational age. A 2022 study notes this risk, while a 2020 study found that 16.3% of pregnant women with RA delivered before 37 weeks. Symptomatic RA during pregnancy may increase the risk of low birth weight, but well-controlled RA does not increase this risk.
Pregnancy can trigger the development of RA in some cases. Women who are susceptible to RA may experience it for the first time immediately after giving birth. This highlights the importance of discussing all medications with your doctors to develop an individualized treatment plan that meets your goals.
In some cases, RA goes into remission during pregnancy. A 2019 study found that 48% of women with RA experienced an improvement in their symptoms during the third trimester, and 25% experienced remission. However, flare-ups after giving birth are common, with 46% of women potentially experiencing flare-ups after delivery.
Women with RA who become pregnant face specific risks related to the disease and treatments such as glucocorticoids, DMARDs (disease-modifying antirheumatic drugs), and biologics. These risks include increased chances of infections, osteoporosis from glucocorticoids, and potential adverse effects from certain medications that require careful dosage management to minimize harm to mother and fetus.
Other studies suggest that RA can make getting pregnant difficult. In a 2011 study, women with RA had a harder time conceiving than those without the disease. Sometimes, it takes 67% of women with severe RA trying for over a year to conceive before becoming pregnant.
Despite these challenges, it is possible to have children if you have RA. Regular prenatal care is essential for a successful and healthy pregnancy and delivery. The American College of Rheumatology notes that with careful medical care, you can have a successful pregnancy and deliver a healthy baby.
It is crucial to remember that each case is unique, and the risks and benefits of pregnancy for individuals with RA should be discussed with a healthcare provider. With proper management, women with RA can plan for and have healthy pregnancies and deliveries.
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