How Rheumatoid Arthritis Affects Pregnancy With Twins
Matthew Brennan, MD
If you're pregnant or planning to be, you may wonder how having rheumatoid arthritis (RA) could affect your pregnancy. Here's some good news: Many women with RA find that their symptoms go into remission during pregnancy. What’s more, RA doesn't seem to affect your chances of getting or staying pregnant. However, certain RA medicines aren't safe to take while you are pregnant. Here's what you need to know about pregnancy and RA.
How Pregnancy Affects RA
Researchers aren't 100% sure why pregnancy may cause RA to go into hiding, but they have several theories. RA is caused when the body’s immune system goes haywire and attacks its own healthy tissues and organs. Researchers believe that pregnancy may dampen your immune system to keep your body from seeing your babies as "foreign" invaders. This means that your immune system doesn't work as actively as it did before, leaving you with less inflammation and pain.
RA Treatment During Pregnancy
Unfortunately, not all women with RA are free from joint pain during pregnancy. Some women don’t improve while they're expecting, and some may have flares.
About 40% to 50% of pregnant women with RA need drug treatment. Experts say pregnant women can safely take the steroid prednisone during the second and third trimester of pregnancy and while breastfeeding. Experts also consider Plaquenil (hydroxychloroquine) safe to take while pregnant.
Prenatal Care Counts
The best way to ensure a healthy pregnancy and healthy babies is the same whether you have RA or not. Like all pregnant women, you should:
- Eat a healthy diet.
- Gain the recommended amount of weight.
Exercise if your doctor says it's OK.
- Avoid tobacco and alcohol.
- Get regular prenatal care.
What Pregnant Women With RA Need to Know
Because you have RA, you need to take a few special precautions during your pregnancy.
Prednisone and pregnancy risks. Taking prednisone in the second or third trimester won't harm your babies, but this steroid may increase your risk of high blood sugar and high blood pressure, so your doctor will keep an even closer eye on your levels. High blood pressure in pregnancy is a risk factor for preeclampsia, which can be life threatening. High blood sugar may mean gestational diabetes, which can increase your risk, and your babies', for a number of health problems. See your doctor for regular prenatal care to help find and treat any problems early.