If you have psoriatic arthritis (PsA), a condition that can be hard to diagnose in Black patients, you are probably used to checking in with your doctor on a regular basis. Regular doctor’s appointments will be even more important throughout your pregnancy so that you are aware of how to keep you and your unborn child safe. Getting your psoriatic arthritis under control will ensure that your pregnancy is healthy and goes the full term.
Although many women with PsA experience a reprieve from symptoms while they are pregnant, a new study shows that the risk for preterm birth and cesarean delivery are increased for pregnancies among women with psoriatic arthritis, and these risks vary with the presence, timing, and type of antirheumatic treatment, according to a study published online Oct. 20 in Arthritis & Rheumatology.
The researchers found that women with PsA pregnancies were more often obese, more often smokers, and more likely to have a diagnosis of pregestational hypertension, preeclampsia and diabetes compared with women with non-PsA pregnancies. Increased risks in PsA pregnancies were most pronounced for preterm birth and both elective and emergency cesarean delivery compared with non-PsA pregnancies.
“From a clinical point of view, all women with PsA, regardless of antirheumatic treatment, should be counseled about pregnancy outcomes and receive individualized monitoring during pregnancy,” the authors write.
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Symptoms during pregnancy
If your PsA does worsen during your pregnancy, you may experience joint pain and swelling that is aggravated by the weight of your baby. You may also experience pain in your back and spine due to changes caused by your growing belly as well as worsened fatigue.
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What to discuss with your doctor
If you are pregnant or looking to become pregnant, you will need to discuss how your treatment plan may have to change. Some medications that are linked to PsA can cause side effects and have been linked to birth defects. Your rheumatologist and obstetrician should be able to weigh the pros and cons of each medication with you.
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Most doctors will reduce the number of PsA medications you are taking and their dosages to tailor them to the needs of you and your growing fetus. Sulfasalazine and cyclosporine are considered safer than other PsA treatments. According to a study, 74% of women who used sulfasalazine during pregnancy did not have an increase in birth defects. Prednisone is also considered safe during pregnancy, but your doctor will need to adjust your dosage depending on the severity of your disease and the trimester you are in.
If you have lower back or severe hip arthritis, you may want to
