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  • Writer's pictureJessica Frizzell, PA-C

Managing Rheumatoid Arthritis During Pregnancy and Conception

Rheumatoid arthritis (RA) is an inflammatory disease that impacts more than 1.3 million Americans as the most common type of autoimmune arthritis, according to the American College of Rheumatology.

And of those RA patients, about 75% are women. In fact, one study reports that “the prevalence of RA is higher in females than males, the incidence is 4-5 times higher below the age of 50.”

Furthermore, research shows that women between the ages of 25 and 45 years old are particularly at risk of developing RA. This means a significant portion of RA patients are women of childbearing age.

Rheumatoid Arthritis and Pregnancy

Having a baby is a big deal - an experience that typically comes with plenty of concern and worry. Having a baby while living with an autoimmune disease is no doubt a big deal and can even feel frightening, intimidating, or confusing.

But the good news is that many women all around the globe have successfully carried and birthed children while managing an autoimmune disease, RA in particular.

It simply requires some attentive preparations prior to conceiving and careful disease management while pregnant.

Before Getting Pregnant

Pre-pregnancy planning is a critical component of having a healthy pregnancy. The medical care leading up to a pregnancy is just as important as the care received during a pregnancy.

“RA should be controlled for 3 to 6 months before attempting pregnancy” as suggested by the Arthritis Foundation. Beginning a pregnancy with well-controlled RA gives you a better chance of carrying a baby full term.

The Use of Medications

Another component of pre-pregnancy planning is medication management.

Under the direction of a rheumatologist, many patients with RA incorporate prescription and non-prescription medications into their RA treatment plan, but NOT all types of medicine are safe to take while pregnant.

Not only should women avoid certain medicines while pregnant, women should abstain from taking many kinds of medicines while trying to conceive, too.

Our bodies like to hang onto and store substances, so eliminating medicines entirely from our system takes time. It is more than just an overnight process.

Some medications, such as methotrexate, need to be stopped several months prior to attempting to become pregnant. Other medications, such as leflunomide, need to be discontinued for years before becoming pregnant, or need to be washed out of the body.

Disease Activity While Pregnant

Pregnancy is different for every woman and it is impossible to predict exactly how a pregnancy will play out, especially when an autoimmune disease is part of the equation.

One woman might go into pregnancy with well-controlled RA and be able to stay stable through the pregnancy, while another might experience increased flare-ups.

Research shows that:

  • 50% of pregnant women “have low disease activity”

  • 20%-40% of women will “achieve remission by the third trimester”

  • Almost 20% of women will have “worse or moderate-to-high disease activity during pregnancy”

If Pregnant or Trying

Women with RA should work together with their OB-GYN and a rheumatologist before, during, and after a pregnancy.

A rheumatologist is the best medical professional to monitor disease activity, manage medications, and track symptoms.

Even if your RA is considered in remission, a rheumatologist should still be a part of your maternal care.

Here at Paducah Rheumatology, we provide care for women of all ages, including those of child-bearing age, trying to conceive, or pregnant.

Give us a call at 270-408-6100 today to make an appointment. New patients require a physician’s referral.

We look forward to helping you have a successful and healthy pregnancy.

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