Rheumatoid Arthritis and Pregnancy

Rheumatoid arthritis and pregnancy are related to each other in an interesting way, which shows that RA subsides during pregnancy! Although it is not the case with all the women, in most women RA is seen to go into remission when they are pregnant. Moreover, the disease does not even affect your chances of getting and staying pregnant, which is seen with other autoimmune diseases like lupus.

The cause of the remission of RA during pregnancy is not definitely known, and there are many theories regarding it. One of the theories is, pregnancy weakens the immune system, so that the fetus is not considered a foreign invader, and RA, like other autoimmune diseases, attacks when the immune system is disturbed and goes on attacking body’s own healthy tissues.

Pregnancy doesn’t provide a sure relief from rheumatoid arthritis to all women and some women show no improvement, while some others suffer flares, while they are expecting.

As per doctors’ observation, 40% to 50% of pregnant women with RA need to be kept on some medication, but it can even be in the form of low doses of steroids or Plaquenil, the anti-malarial. Both these drugs are considered to be safe in pregnancy and breastfeeding.

According to another observation, there may be aches and pains while the woman is expecting, which are not necessarily flares, but are just a part of pregnancy. Other side of this is, RA may come up during the period after delivery. However, this too is not a rule, as there are women who do well during this period.

The relation between rheumatoid arthritis and pregnancy may be considered from the point of view of breastfeeding too. In fact, there are certain drugs which cool down the inflamed joints, which can be taken safely during breastfeeding. However, rheumatologists’ main weapons, like methotrexate and biologics, cannot be taken during this period. Of course, there are other medicines, if pain and inflammation becomes unbearable, in postpartum period, but they take some to time to show effect.

Rheumatoid Arthritis and Pregnancy

Whether or not you are a RA patient and if you are pregnant, prenatal care is a must. Your diet should be healthy and non-weight-gaining. You should exercise under your doctor’s supervision. You should not smoke or consume alcohol and also should not have fish containing mercury. If there is fish oil supplement in your diet, you should confirm with your doctor that it is free of mercury. Another must is calcium and vitamin D, especially if you are on prednisone, which causes more bone loss.

One more fact about prednisone is, though it is safe in pregnancy, it may cause increased blood pressure and blood sugar. Both these are risk factors, as, elevated blood pressure increases the risk of pre-eclampsia, and higher blood sugar increases the risk of cesarean section delivery. Therefore regular monitoring of these two is very necessary.

Another significant prenatal care factor is dental heath. Gum disease is associated to preterm labor and RA patients are more prone to develop gum disease.

But the most relieving fact about the connection between rheumatoid arthritis and pregnancy is, the disease is not transmitted to the baby from the mother suffering from RA, though it happens with other autoimmune diseases. Doctors have the best news for the would-be mothers suffering from RA that, most women with RA and their babies live very well, both during pregnancy and afterwards.