Arthritis and Pregnancy – Arthritis at a young age is not the end especially if you are planning to have children. It is important to remember that arthritis could affect your pregnancy and your pregnancy may also affect your arthritis. Yes, a bit circular.
Table of Contents
- 1 Arthritis and Pregnancy – planning for a baby
- 1.1 When is the best time to have a baby?
- 1.2 Should I stop all my drugs before becoming pregnant?
- 1.3 Does it matter if the father is taking drugs for arthritis?
- 1.4 What supplements should I take?
- 1.5 What are the chances of my child having arthritis?
- 1.6 Conception and fertility problems
- 2 Arthritis and Pregnancy – Planning for the delivery
Arthritis and Pregnancy – planning for a baby
Some of the Arthritis medication you take might influence the baby. It is vital that you discuss your Arthritis and pregnancy plans with your physician or specialist nurse before you start trying for a baby, or if you become pregnant unexpectedly. This is because your treatment plan might also need to be changed. The main concern is for you to improve your chances of having a safe pregnancy and delivering a healthy baby.
When is the best time to have a baby?
It is recommended that you try conceiving a baby while you’re in a relatively good phase with your arthritis to reduce the potential of the arthritic drugs influencing the baby.
Points to remember:
- Most women with lupus who want to become pregnant should do so during a quiet remission phase.
Should I stop all my drugs before becoming pregnant?
You shouldn’t stop taking prescribed drugs without talking to your doctor first. For all your arthritis and pregnancy concerns, you should remember that a lot of drugs can be continued safely in pregnancy.
Some drugs may have to be stopped before you get pregnant because they may be harmful to the baby. You should not attempt to conceive while you’re on:
- non-steroidal anti-inflammatory drugs (NSAIDs)
Your doctor will prescribe alternatives for your arthritis and pregnancy considerations which may include:
- the safest combination of drugs at the lowest reasonable dose that will keep your arthritis under control.
- other pain-relief treatments, such as physiotherapy and acupuncture.
Does it matter if the father is taking drugs for arthritis?
The impact of arthritis medication on arthritis and pregnancy is not only limited to the woman. Some arthritis medication can cause problems in men trying to father a child.
The following drugs should be stopped at least 3 months prior to attempting to conceive:
- Cyclophosphamide – which can reduce fertility in men
To improve sperm count, you can:
- Eat a healthy diet
- Stop smoking
- Reduce alcohol intake
- Reduce caffeine intake – coffee, tea, energy drinks, soft drinks
What supplements should I take?
Please consult with your physician regarding the most effective supplements for pregnancies. The following are generally recommended:
- Folic acid – Take every day from three months before the time of conception until 12 weeks into the pregnancy
- Methotrexate – a normal dose that can be increased depending on whether you stopped taking methotrexate more than three months before getting pregnant. Check with your doctor as methotrexate could affect folic acid levels
An Arthritis and pregnancy caution:
- Avoid supplements other than folic acid and iron unless you have a specific deficiency, such as a lack of vitamin D.
- If you are taking steroids during pregnancy, you may consider taking calcium and vitamin D to prevent Osteoporosis
What are the chances of my child having arthritis?
Not all forms of Arthritis are hereditary. Your decision to have children should not be influenced by Arthritis. Consult your doctor regarding the risks associated with your Arthritis.
Osteoarthritis is rarely passed on from parent to child. The one form of osteoarthritis that does run strongly in families is nodal osteoarthritis. Nodal osteoarthritis affects mainly women and causes firm swellings on the fingers and often swelling at the base of the thumb, just above the wrist.
However, Nodal osteoarthritis usually doesn’t start until women are in their 40s or 50s, around the time of the menopause, so you may not develop it while you’re of child-bearing age. The chance of nodal osteoarthritis being passed on from mother to daughter is about one in two (50%).
The risk of passing on psoriatic arthritis to your child is probably like the risk for rheumatoid arthritis at about one in 30, although the risk of the child developing psoriasis is higher.
The risk of passing RA from parent to child is very low. Although still being researched, the risk of a child inheriting rheumatoid arthritis from a parent is between 1 in 100 to 1 in 30 (about 1–3%) so they’re far more likely not to get it than to get it.
Just like rheumatoid Arthritis, the risk of passing on psoriatic arthritis to your child is about one in 30, although the risk of the child developing psoriasis is higher.
The risk of your child developing Lupus later life is about one in 100. The risks are greater for other relatives because of the way the genes involved work. For example, one in 33 (3%) for the sister of someone with lupus (the risk is lower for brothers).
Conception and fertility problems
Active Arthritis will not affect your fertility. However, it may take you longer to conceive. Additionally, there is an increased rate of miscarriage in some patients with lupus and antiphospholipid syndrome (APS).
The main underlying risk factors are that make it a bit difficult to get pregnant are:
- The disease being active
- Taking certain drugs (such as cyclophosphamide)
That is why it is recommended to attempt to conceive when your arthritic conditions are under control and to stop certain potentially harmful drugs in advance.
Arthritis and Pregnancy – Planning for the delivery
Normally, ultrasounds are recommended to:
- check the dates of the pregnancy (at 11-12 weeks)
- look for any abnormalities in the pregnancy (11-12 weeks)
- check that everything is fine (18-20 weeks)
For women with Arthritis, additional detailed scans may sometimes be needed if
- You have taken medication during the pregnancy that may cause problems
- you carry anti-Ro antibodies in your blood
Should any complications arise, the doctors can then discuss the implications and options available to you.
Will I be able to do my exercises?
As a rule, it is vital that you keep exercising for as long as possible during your pregnancy.
With the advance of your pregnancy, you will gain weight. You may also find it easier to exercise in a swimming pool, where the water will help to support your weight.