Rheumatoid arthritis and pregnancy

• In the past there were concerns that RA might affect the ability to conceive. But with recent advances it is clear that if the disease is well controlled, most women with RA can have an enjoyable and successful pregnancy. 
• The risk of foetal loss or genetic abnormalities for women with RA is not significantly greater than for any other pregnant women.
• Planning ahead is the key. Before you try to conceive, it’s important that you discuss with your rheumatologist.
• It is recommended to become pregnant when the disease is not active.
• All women who are planning to get pregnant should take folic acid supplements daily. 
• Many patients may not need RA medications during the pregnancy if their disease is not active. The pain and swelling associated with RA is much improved during pregnancy in up to 75% women.
• Some of the drugs used to treat RA can be continued while trying to conceive or even during the pregnancy. It is advisable to consult with your rheumatologist before you stop any drugs.
• Certain medications like methotrexate and leflunomide should be stopped well in advance. There are medications like sulfasalazine, hydroxychloroquine and steroids are safe during pregnancy and breast feeding.
• Although you may be concerned about the possible harmful effects of taking RA drugs, it is important to remember that uncontrolled arthritis during pregnancy can also have adverse effects on your baby such as low birth weight.