Rheumatoid arthritis (RA) affects pregnancy. Most of the pregnant women with RA have low disease activity during pregnancy (60%) and may achieve remission by the third trimester as well. Few women may have worse or high disease activity. RA can lead to complications like preterm birth, raised blood pressure (preeclampsia), and low birth weight babies.
Overall, the women who have well-controlled RA have healthier pregnancies and newborns compared to women with active disease.
How does pregnancy affect rheumatoid arthritis?
Researchers state the various factors that improve the symptoms of rheumatoid arthritis in pregnancy:
- Overall suppression of the immune system to prevent seeing the fetus as a foreign object
- Hormonal changes that decrease disease activity during pregnancy
- Increased level of anti-inflammatory substances in the blood that reduce inflammation and pain
- Decreased levels of reaction causing proteins in the blood
- Decreased white blood cell function during pregnancy
The overall suppression of the immune system and the release of anti-inflammatory decrease the RA activity in pregnant women. It also reduces inflammation and pain during pregnancy.
How will pregnancy affect my rheumatoid arthritis symptoms?
Approximately 60% of women experience improvement in rheumatoid arthritis symptoms throughout pregnancy. Around 20% of women can have their symptoms worsened during pregnancy. The exact mechanism for this variation is still being researched.
What effect does rheumatoid arthritis have on the baby?
RA may lead to low birth weight babies. Of the newborns, 3-5% may have birth defects. There are a few antirheumatic drugs that have the potential to cause birth defects. However, most of the time, pregnant women with RA have healthy pregnancies and babies provided adequate precautions have been taken. A few drugs may need to be discontinued well before conception. Consult with your doctor before you plan a baby.
What do pregnant women with rheumatoid arthritis need to know?
Women with rheumatoid arthritis should take special precaution during pregnancy:
- Taking steroids may increase the risk of increased blood sugar and blood pressure levels. High blood pressure and high blood sugar can cause preeclampsia and gestational diabetes, respectively. These can be life-threatening and increase the risk for mothers and babies.
- Prednisone increases the risk of bone loss; hence, taking calcium and vitamin D is essential.
- Take mercury-free fish oil to fight inflammation.
- There might be an increased risk of gum disease in women with RA. Gum disease can increase the chance of preterm birth.