Effect of pregnancy on arthritis
Arthritis is a term that refers to swelling, stiffness, and pain in the joints. Psoriatic arthritis (PsA) is one type of arthritis that occurs in some individuals who have the skin condition psoriasis. Studies suggest that PsA may occur more frequently when a person has severe skin psoriasis and when there is a family history of PsA. About 1-2 per 1000 persons has PsA and it is just as likely to occur in women as men, and therefore women can have this condition during the child-bearing years
Fewer than 20% of female patients develop arthritis before their first pregnancy. Like rheumatoid arthritis, there is evidence of a hormonal influence on the occurrence of PsA. For most, the time after having a baby and the time during menopause are two common times for developing arthritis and it is possible that hormonal factors at these times may trigger the onset of arthritis. Although the activity of arthritis and psoriasis can be variable during pregnancy, and in general it seems to improve during pregnancy and flare after the birth in a similar way to rheumatoid arthritis.
A study of ten women with PsA suggested that PsA does not negatively affect pregnancy outcomes and these women all had mild skin psoriasis. For the majority, but not all, of these women, PsA symptoms improved during pregnancy but returned to pre-pregnancy disease activity after delivery. Doctors are not able to predict for any one woman whether her symptoms will improve, stay the same, or worsen during or after pregnancy.
Arthritis has the potential to affect pregnancy at every stage from conception to the weeks following birth. And pregnancy can make a difference it may be either good or bad. But predicting the course of pregnancy much less the course of a variable disease during pregnancy is impossible.
Medication concept for psoriatic arthritis patient during pregnancy
Although medications should be limited during conception and pregnancy, this may be impossible for those who have psoriatic arthritis. Some pain medications can be used safely during pregnancy. Talk with your doctor about all over-the-counter and prescription medications you take before conception, during pregnancy.
Many patients are concerned about the effects of their medications on conception and pregnancy. There are no universal guidelines and medication needs to be tailored to individual needs. The general advice is that most medications used for arthritis during pregnancy are safe, although it is sensible to keep medications to a minimum. Patients should be reassured that if a particular medication does need to be stopped for any reason, there are alternatives.
Both female and male patients with PsA should discuss a planned pregnancy with their rheumatologist, dermatologist or GP so that the best advice about their particular medication is given. This is particularly important for patients on disease modifying therapy. Men with PsA taking sulfasalazine should be aware that the drug may reduce the sperm count. And make sure that do not take any medication without consulting your dermatologist while you are pregnant.