• What changes can happen during pregnancy?

    It is sometimes difficult to distinguish between the common discomforts of pregnancy and the symptoms of RA. Pregnancy discomforts that are similar to those of RA include the following: 1) Fatigue, 2) Swelling of the hands, feet, or ankles, 3) Joint pain, especially in the low back, 4) Shortness of breath, and 5) Numbness or pain in one or both hands (caused by carpal tunnel syndrome of pregnancy).

    Can Rheumatoid Arthritis affect my Baby?

    Rheumatoid arthritis itself doesn’t seem to harm the developing baby, even if RA is active during pregnancy. In fact, 70%-80% of women with RA have improvement of their symptoms during pregnancy. Although some women with RA may have a slight risk of miscarriage or low-birth-weight babies, the vast majority of women have normal pregnancies without complications. However, many drugs for rheumatoid arthritis — including methotrexate and leflunomide, can cause birth defects. These same medications may also cause birth defects if men who father children take them. Therefore, it’s important to talk to your doctor about altering treatment several months before you or your spouse try to get pregnant.

    When should I talk to my doctors about my medications?

    As soon as you’re considering starting a family, see your rheumatologist. Some drugs need a months-long period before trying to conceive. And that goes for men as well as women; although unproven, methotrexate might result in sperm problems that could cause birth defects. If you’re taking leflunomide, even more advance planning is necessary. Due to its long half-life, leflunomide needs to be stopped two years before trying to conceive a baby.

    What supplements should I take during pregnancy?

    All women who want to have a baby should take a folic acid tablet every day from 3 months before conception until 12 weeks into the pregnancy. You should avoid supplements other than folic acid and iron unless you have a specific deficiency, such as a lack of vitamin D. If you’re taking steroids you may also be advised to take calcium and vitamin D tablets to help protect against osteoporosis.

    What are the chances of my child having arthritis?

    The risk of passing most types of arthritis onto your children is small. As most forms are unlikely to be passed on from parent to child, this shouldn’t affect your decision to have children. If you’re worried you may want to try genetic counseling.

    What happen after the birth of my baby?

    You may find that you need extra help after your baby is born, so think about this before the birth and talk to your doctor if you need to. They’ll probably recommend going straight back on any medication you might have stopped during the pregnancy, except where the drugs would affect breastfeeding.

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