Pregnancy, Autoimmune Diseases and Joint Pain

Joint pain is one of the most common symptoms among people who suffer from autoimmune diseases – where the immune system attacks healthy tissue.

About 50 million Americans -- the vast majority of them women, especially women of working and childbearing age -- suffer from autoimmune ailments. Unfortunately, that is just the timing when many women are planning their families.

family planning with joint pain

While it was once inadvisable for women with autoimmune diseases to get pregnant, there is new research to the contrary. Depending on the disease, many women are able to safely have children. There are, of course, potential risks for the mother or child, though it depends on both the disease and its severity. There are steps that pregnant women with autoimmune diseases can take to reduce their risk.

Rheumatoid Arthritis is one of the many autoimmune diseases that can cause pregnancy complications. However, 70-80% of the women suffering from RA have noticed improvement of their symptoms during pregnancy, at least by the third trimester. Some women have had slight risks of miscarriages, as well as low birth weight babies. There are various medications that patients take for RA, however they can cause birth defects as well. It is imperative to those trying to start a family that they speak to their doctor several months in advance. Medications may be able to be altered, or dropped completely depending on tests done by the doctor. If necessary, they can prescribe medications that are suitable for pregnant women, such as low doses of prednisone, hydroxycholoquine and sulfasalazine. However, the best way to avoid risk is to simply not take any medications during conceiving, delivery and breast-feeding.

Those suffering from antiphospholipid syndrome have an increased risk of blood clots in their veins and arteries. These can lead to obstetric complications like miscarriage, prematurely born babes or high blood pressure during pregnancy. Pulmonary hypertension is a risk for those with Lupus, APS, Sjogren and Scleroderma. These particular diseases are often worse during pregnancy, leading doctors to suggest that those suffering with these not to get pregnant. On the other hand, Scleroderma, Polymyositis, Dermatomyositis and Vasculitis appear to be unaffected by pregnancy.

The disease and the joint pain that accompanies it may complicate and prolong conception. In 2011, a study was done with 68,000 pregnant women. They had women with, as well as without, RA, and it demonstrated that 25% of the women with Rheumatoid Arthritis had to try for at least a year before conceiving. However, only 16% of those without RA had to try for as long. Doctors are currently uncertain if it is due to the disease, or to the medications. In 1999, a study of 140 women showed that 63% found their symptoms had improved by the third trimester. In 2008, a similar study found that patients felt better during pregnancy, but had flare ups occur after the delivery. In 2011, a study with over a million women born between 1962 and 1992 showed that 25,000 of them developed autoimmune diseases like rheumatoid arthritis. However, 15-30% showed greater risk of contracting it in their 1st year after giving birth. In 2010, data from the Taiwan National Health Insurance Research Database demonstrated that women with RA had an increased risk of delivering a baby with low birth weight or that was smaller than their gestational age. They also showed a higher risk for high blood pressure, and the likelihood of having to use a c-section was increased.

There are many complications that can arise. However, proper preparation is the first way to being able to safely maintain one's pregnancy. For instance, in the event of preeclampsia, which is high blood pressure, one has the possibilities of seizures, kidney problems or even death of the mother and/or child. To ensure that the patient is safe, doctors should provide increased monitoring of the baby and mother's health. If the mother halts her medication, there is an increased risk of joint damage from flare-ups of the disease. With lupus, there is a higher risk of premature birthing and stillborn. Myasthenia Gravis can lead to troubled breathing during the pregnancy, which can affect the baby or mother negatively. Some women with autoimmune diseases will have difficulty even conceiving, although there are many tests that can be done to know if their fertility problems are caused by the disease or by something unrelated.

The best advice to cope with joint pain and fertility problems is to be cautious and to get the best quality medical care from a doctor who understands the complications of autoimmune diseases and child bearing.

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