Female Reproductive Health And Autoimmune Diseases

Rheumatoid Arthritis

Rheumatoid arthritis does not lead to subfertility or infertility, and the condition often actually goes into remission during pregnancy. The reason is not known yet, but a less active "pregnancy immune system" might be to thank. Though this is good news for many women with RA who are pregnant or would like to conceive, not all expectant moms with rheumatoid arthritis are symptom-free, and some have flare ups.

Prednisone has been deemed safe once the first trimester is over, and the same goes for Plaquenil. These medications do put women at a higher risk of hypertension — which in turn raises the risk of the life-threatening condition preeclampsia — and high blood sugar levels. Pregnant women taking Prednisone will need extra vitamin D and calcium to protect their bone health as well. 

Type 1 Diabetes

Women with type 1 diabetes, particularly poorly controlled diabetes, still have a higher risk of pregnancy complications. For the baby, these risks include miscarriage, premature labor, birth defects, a very large baby, hypoglycemia at birth, and breathing difficulties. Diabetes-related eye and kidney problems can worsen during pregnancy, and preeclampsia and a difficult delivery are also potential problems for diabetic mothers. 

Planning a pregnancy carefully and having excellent blood glucose control for six to three months before attempting to conceive are good ideas. Keep in mind that many medications used to treat diabetes are not safe during pregnancy. ACE inhibitors and statins are examples. The medical issues surrounding diabetes during pregnancy make discussing family planning with their healthcare team absolutely essential for women with the disease.

Multiple Sclerosis

Multiple Sclerosis strikes women of reproductive age more than any other group of people. Fortunately, there is no evidence that MS leads to fertility problems, an increased risk of miscarriages, or birth defects. Women with Multiple Sclerosis were told to avoid getting pregnant before 1950 because doctors believed pregnancy would worsen the disease.

Relapses are more likely to happen during the immediate postpartum period, however, and the fact that many MS medications are not approved for use during pregnancy does mean getting pregnant with MS is not necessarily completely straightforward. Women whose mobility has been affected by MS may well find that their problems increase while they are expecting a baby, and the may need to rely on walking sticks or wheelchairs. 

See Also: Women with Multiple Sclerosis are as Likely as Other Women to Have a Healthy Pregnancy

Want To Conceive With An Autoimmune Disease?

If you are a woman with an autoimmune disease and you'd like to get pregnant, it is likely that your disease will impact your reproductive life in some way. Likewise, a pregnancy can influence the disease you have positively or negatively. Not all medications are safe for use during pregnancy, and in some cases it is very important that healthcare and lifestyle changes are implemented some months before you start trying to conceive.

All these factors can only lead to an extremely simple bit of advice: any woman who was diagnosed with an autoimmune disease and is either thinking about getting pregnant now, or might possibly want children in the future should talk to her healthcare team about fertility, pregnancy, and the disease.