Rheumatoid arthritis and pregnancy

There is usually an improvement in rheumatoid arthritis during pregnancy. This may be due to the increase in pregnancy related globulin that has anti-inflammatory properties.

Regarding treatments used in rheumatoid arthritis:

• the use of methotrexate during pregnancy is contraindicated (teratogenic); manufacturer advises the use of effective contraception during and for at least 6 months after administration to men or women
• suphasalazine may be used if there is folate supplementation; theoretical risk of neonatal haemolysis
• azathioprine use may result in intra-uterine growth retardation
• penicillamine may result in weakened fetal collagen
• non-steroidal anti-inflammatory drugs can be used during pregnancy but there use is not recommended during the third trimester. This is because they may cause premature closure of the ductus arteriosus. The use of non-steroidal anti-inflammatories during late pregnancy has also been associated with renal impairment in the newborn