Rheumatoid Arthritis (RA) is more common in women than men in the ratio of 1:3. Many women with RA are diagnosed in their 20’s and 30’s. Women with RA should consult the rheumatologist (arthritis specialist) and an obstetrician before becoming pregnant. Few drugs like methotrexate should be stopped three months prior to attempting pregnancy, as they cause congenital abnormality in the fetus.
Similarly, drugs like leflunomide should be discontinued at least 2 yrs before attempting conception. However, non- steroidal anti-inflammatory drugs can be taken more safely during the second half of pregnancy under supervising of the doctor.
Rheumatoid Arthritis can affect fertility:
Rheumatoid Arthritis does affect fertility such women take a longer time to conceive due to inconsistent ovulation, decreased sex drive (libido) and having infrequent sex due to pain, fatigue and not feeling well. Even in men, it can produce reduced sperm count and erection problems and decreased lipids.
If you have Rheumatoid Arthritis: Plan your pregnancy
With medical advancements and newer drugs, early and aggressive treatment can avoid joint deformities and major disabilities; pregnancy can be planned and carried out smoothly under the supervision of a doctor. Pregnancy alters the immune state and it has been found that in 50- 60% of cases, the disease activity decreased but again there is a flare up in the postpartum period i.e. after delivery.
Rheumatoid Arthritis can complicate your pregnancy:
There the disease itself does not cause any major obstetric complications, but few cases of miscarriage and growth retardation of baby hair been reported. There is no need to do a cesarean section because of Rheumatoid arthritis but C- Section can be done due to other obstetrical indications. Taking corticosteroids during pregnancy may not harm the baby, but it may increase the blood pressure and blood sugar of the mother. So, always consult the doctor for these two problems monitoring. Take a good prenatal vitamins, calcium and vitamin D as prednisolone causes risk of bone loss.
Breastfeeding should be done in patients with RA, but again drugs like methotrexate, leflunomide, cyclophosphamide should not be started. The flare-up of the postpartum period for the breastfeeding mothers can be treated with short-acting no steroidal anti-inflammatory drugs (NSAID); low dose aspirin, Prednisolone in low doses, azathioprine.
After delivery, she can go for birth control pills or any other method of contraception.