Rheumatoid arthritis (RA) can affect pregnancy, but well-managed RA reduces these chances.
Read on to learn how RA may affect your pregnancy.
Yes, you can have children if you have RA.
The American College of Rheumatology notes that with careful medical care, you can have a successful pregnancy and deliver a healthy baby.
In a 2011 study including more than 74,000 pregnant Danish women, those with RA had a harder time conceiving than those without the disease: 25% of those with RA had tried for at least 1 year to conceive before they became pregnant, and about 16% of those without RA tried that long before becoming pregnant.
Other studies also suggest RA can make getting pregnant difficult. Research from 2019 found that 67% of women with severe RA tried for over 1 year to conceive before becoming pregnant.
There are several factors that can contribute to this: RA itself, the medications used to treat it, and the fact that people with RA often experience early menopause.
You may not have any issues, though. If you do, your care team can help you learn about your options.
Sometimes, RA goes into remission during pregnancy.
Research from 2019 found that 48% of women with RA experienced an improvement in their symptoms during the third trimester and 25% experienced remission.
In a 2019 review,
On the other hand, flare-ups after giving birth are common. According to research from 2020, 46% of women could experience flare-ups after delivery.
You and your doctor can work together 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 cases.
People who are susceptible to RA may experience it for the first time immediately after giving birth.
A 2024 population-based study including more than 1.7 million births found that people who had pregnancy complications were more likely to develop autoimmune diseases up to 19 years after giving birth.
Additionally, rates of celiac disease, RA, multiple sclerosis, and systemic autoimmune rheumatic diseases were generally higher after births affected by pregnancy complications.
According to a 2023 review and meta-analysis, RA can increase the risk of preeclampsia.
Preeclampsia causes high blood pressure during pregnancy. Complications include seizures and kidney problems. It can be life threatening to the mother and baby.
Preeclampsia typically starts after 20 weeks of pregnancy. It can be present without any noticeable symptoms. Doctors usually discover it during prenatal checkups.
When it is discovered, doctors increase monitoring and treat when needed to ensure the 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 the timing of delivery.
RA may increase the risk of premature delivery. A 2020 study including 657 pregnant women with RA found that 16.3% of them delivered before 37 weeks, which is considered premature.
A 2022 study also notes RA may increase the risk of babies who are preterm or small for gestational age.
Symptomatic RA during pregnancy may increase the risk of delivering babies with low birth weight, according to a 2023 review and meta-analysis.
However, when RA is well managed, this risk decreases. A
Some studies indicate that RA medications may increase the risk of pregnancy complications.
Certain disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and leflunomide, can be toxic to a fetus.
However, other DMARDs, such as sulfasalazine, are not harmful during pregnancy and do not cause issues after delivery.
Talk with your doctors about all the medications you’re taking. Together, you can discuss the benefits and risks of taking them and develop an individualized plan that meets your treatment goals.
RA can affect pregnancy, but the disease should not stop you from planning to have children. The important thing is to get regular checkups with your care team.
With careful prenatal care, you can have a successful and healthy pregnancy and delivery.