Arthritis during pregnancy: Risks and treatment

Arthritis is known for affecting joints throughout the body. Pregnant women with arthritis may feel more pain and discomfort in the knees or spine due to the additional weight. While the condition itself does not impact a woman’s ability to get pregnant, you need to be cautious when it comes to taking the medications for arthritis. There may be complications if you have arthritis during pregnancy. Read on to know if arthritis during pregnancy can affect your unborn child.

Can arthritis develop during pregnancy?

Developing arthritis during pregnancy is uncommon, but existing symptoms may alter due to hormonal and immune system changes, says obstetrician, gynaecologist and laproscopic surgeon Dr Asha Hiremath. You may experience swelling in the hands or feet joint pain or have difficulty breathing and tingling or pain in the hands. So, while planning a pregnancy with arthritis, it is essential to consult both a rheumatologist and an obstetrician, review medications, and discontinue any drugs before trying to conceive.

The link between hormonal changes and arthritis

Hormone fluctuations during pregnancy can affect arthritis symptoms. Here’s how!

1. Estrogen levels

Estrogen is known to have anti-inflammatory properties, and its levels typically rise during pregnancy. In some women with arthritis, this increase in estrogen can lead to temporary relief from joint pain and inflammation, particularly in rheumatoid arthritis, which is a chronic inflammatory disorder affecting joints. However, not all women experience this benefit, and some may still have active arthritis symptoms despite hormonal changes.

2. Progesterone levels

Progesterone is another hormone that increases during pregnancy. While progesterone itself is not directly linked to arthritis, its effects on ligaments and joints can contribute to joint instability and discomfort, especially in weight-bearing joints such as the hips and knees. This can be particularly noticeable in the later stages of pregnancy as the body adapts to accommodate the growing fetus, says the expert.

What are the risks for a pregnant woman with arthritis?

Women with rheumatoid arthritis are at increased risk of various complications when compared with those who do not have the disorder. According to a 2010 study published in the Annals of the Rheumatic Diseases journal, they may have babies that are smaller-than-average size or have low birth weight. Here are some of the risks:

1. Low birth weight

Pregnancy-related arthritis may cause smaller-than-average babies, which could have negative health effects on the unborn child. On average, their size should be between 2.5 and 4 kg. If they are too small, they may experience respiratory distress syndrome (RDS), which is characterised by difficulty breathing due to immature lungs. They may require oxygen therapy or mechanical ventilation to support their breathing, says Dr Hiremath.

2. Premature birth

Mothers who have arthritis are more likely to give birth early, says the expert. This raises the possibility of difficulties for both the mother and the unborn child. Premature babies have an immature immune system, making them more susceptible to infections such as sepsis, pneumonia, and meningitis. Premature birth is associated with a higher risk of neurodevelopmental issues, including cognitive delays, learning disabilities, attention deficits, and behavioural problems.

3. Miscarriage

A study published in The Journal of Rheumatology in 2015 was done to know the risk of pregnancy loss in women with rheumatoid arthritis. Researchers found the risk of miscarriage to be slightly higher among women with the disorder than others.

Managing arthritis pain during pregnancy

Managing pain associated with arthritis during pregnancy might involve using acetaminophen (paracetamol) for mild to discomfort, says Dr Hiremath. Generally, non-steroidal anti-inflammatory drugs should be avoided, after 20 weeks of gestation. You may also the following:

• Before getting pregnant, talk to your doctor about your arthritis medications and their potential effects on the baby.
• Pregnancy can worsen arthritis symptoms, but you can alleviate discomfort with hot or cold packs, rest, good posture, and relaxation techniques.
• Keep moving by doing exercises like walking and swimming, but consult your doctor first.
• Work with a physical therapist to learn exercises and techniques tailored to ease joint pain and improve mobility.