I’ve received many letters and requests for a post about Rheumatoid Arthritis and pregnancy. Here it is – our long-awaited first post on RA and pregnancy. I look forward to hearing many of your experiences which will be helpful to others as they look for answers in the months to come.
The decisions of Rheumatoid Arthritis and pregnancy
Pregnancy remissions of RA are very common, but a woman living with RA has some complex decisions to make regarding pregnancy. Can she safely carry a baby? How will the pregnancy affect her RA? Will she be able to care of a baby? What RA medicines can she take while pregnant? Where can she turn for answers?
Medicines for Rheumatoid Arthritis with pregnancy
This is not like cheesecake– there is no recipe. Like many decisions related to Rheumatoid Arthritis and pregnancy, considering medicines involves judgment calls. The best thing to do is to get as much information as possible and find two specialists that you can trust – one for Rheumatoid Arthritis and another for higher risk pregnancies.
Some medicines are considered safe during pregnancy (see the links at the end of this post). Several RA medicines are out of the question such as methotrexate and Leflunomide because they can lead to abortion or birth defects. Other RA medicines are considered acceptable only at certain doses or during certain trimesters, such as prednisone or ibuprophen. Other RA medicines, like Enbrel and Humira, have not been sufficiently tested to be given a specific rating for pregnancy by the US FDA. However, initial data looks promising. (See OTIS link below.) Several readers of this blog have commented that they have used them safely during pregnancy. Here is a Medscape detailed discussion of RA medicines and pregnancy.
Newest research on Rheumatoid Arthritis and pregnancy
A new report, “Management of rheumatic diseases during pregnancy,” by Doctors Amy B. Elliott and Eliza F. Chakravarty explores “concerns regarding medication use, changes in disease activity during pregnancy, safety of lactation, and future ability to care for a child given the presence of chronic illnesses.” It’s written for doctors and medical students, but if you are doing research, it could be useful. The free abstract describing the report can be read at this link (the full report is locked on several medical sites). But guess what I found? Amazon has the Kindle version of the whole report on Rheumatoid Arthritis and pregnancy for $1.99 at this link!
Valuable resources for Rheumatoid Arthritis and pregnancy
- “The Nine Month Arthritis Cure,” The story of a lady rheum specialist with a quest to solve the mystery of Rheumatoid Arthritis and pregnancy back in the 1980’s. Dr. Nelson demonstrated that the more genetically different a baby is from his mother, the more likely she is to have a pregnancy remission.
- OTIS Autoimmune Diseases in Pregnancy Project is studying the effects of RA / PA/ AS medicines on pregnancy. Check their resources or volunteer your information if you are pregnant with an autoimmune disease.
- “A Mother’s Tale,” the story of Amy’s decisions regarding Rheumatoid Arthritis and pregnancy, written by a female rheum doctor for John’s Hopkins.
- An excellent overview of medical issues related to Rheumatoid Arthritis and pregnancy on Medscape.
- A list of medications considered “safe” during pregnancy, with explanations of the five safety classes.
- A story about Rheumatoid Arthritis and pregnancy: A Summer Read for Rheumatoid Arthritis Warriors!
- Rheumatoid Arthritis Warrior’s Angel Puppy, Gabriel