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A study done in Denmark on about 68,120 women who became pregnant between 1996 and 2002 has come to the conclusion that presence of Rheumatoid Arthritis makes it difficult for the women to conceive.

Women with Rheumatoid Arthritis Find It Hard To Get Pregnant

According to the study, published in the journal Arthritis and Rheumatism, it was found that almost 25% women suffering from RA tried unsuccessfully for a year to conceive before finally getting pregnant as compared to 16% women who did not have RA. 10% of women with RA were treated for infertility as compared to 8% women without RA. 41% of women with RA got pregnant within 2 months of trying as compared to 48% women who did not suffer from RA. Thus it was concluded that rheumatoid arthritis makes it difficult for the women to conceive. Though the disease does not affect the fertility rate, it seems to increase the time to pregnancy.

It is difficult to say whether the time to pregnancy increases because of the rheumatoid arthritis or because of the various medicines taken to counter RA. There is no evidence till date to suggest that RA hinders pregnancy. However, the patients of RA trying to conceive are asked to stop their medications beforehand as these may have deleterious effect on the fetus. Medicines like methotrexate are known to produce birth defects whereas newer disease modifying anti-rheumatic drugs (DMARDs) like etanercept and infliximab have not been studied enough for their effect on the developing embryo. It has been hypothesized that this sudden stoppage of treatment for RA results in the flaring up of the disease which may somehow be related to difficulty in conceiving.

Rheumatoid Arthritis has different effects on the different stages of pregnancy

Rheumatoid Arthritis is an autoimmune disease commonly affecting the women, wherein the body’s immune system fails to recognize its own tissue and starts damaging the joints resulting in pain, inflammation and subsequent destruction of the joints. Women suffering from RA may take longer to conceive because of inconsistent ovulation; and fatigue and pain leading to a decrease in sex drive.

Before trying to conceive, it is better to consult the doctor so that any harmful medication is tapered off or is replaced by some other safe alternative. Different medications for RA take different time to be completely washed away from the system. RA has different effects on the different stages of pregnancy. During the first trimester of pregnancy, women suffering from RA tend to get more fatigued. Almost 70 to 80% women report an improvement in their symptoms during the second trimester of pregnancy. This is especially true in women who are negative for the rheumatoid factor and anti CCP autoantibody. The fatigue worsens once again with the onset of the third trimester though now it is more related to the growing weight of the baby. RA increases the chances of an early labor and delivery of a premature baby. The likelihood of undergoing a cesarean section to deliver the baby is also more. This is because of the involvement of the hip joint by the arthritis. RA tends to flare up in the post partum period. Getting back with the old medication that the patient was taking before pregnancy should be discussed with the doctor in view of breast feeding.

Though women with RA take slightly longer to conceive, the delay is not very significant. It is advisable for such women not to put their plans of having a baby on hold as it will be more difficult to conceive in the late reproductive years.

  • Damini Jawaheer,Jin Liang Zhu,Ellen A. Nohr,Jørn Olsen. Time to pregnancy among women with rheumatoid arthritis. DOI: 10.1002/art.30327. American College of Rheumatology
  • Photo courtesy of Torsten Mangner by Flickr :