Rheumatoid arthritis and pregnancy

This study explored whether rheumatoid arthritis (RA) disease activity during one pregnancy can predict disease activity in further pregnancies. The study showed that disease activity in one pregnancy does not predict disease activity in further pregnancies. However, disease activity flare-ups after giving birth may predict flare-ups after further births.

Pregnancy is often associated with a decrease in RA symptoms. Previous studies have reported that improvement in RA disease activity during a first pregnancy predicted improvement in disease activity in further pregnancies. However, these studies were based on reports given in hindsight and did not monitor and measure disease activity throughout pregnancy. Understanding whether there is a trend in RA flare-ups during and after pregnancy would help doctors to better assess and meet the needs of the patient. 

This study included 27 patients with RA who had two successful pregnancies. The average age of the patient was 31.2 years and each had RA for an average of 6.5 years before the first pregnancy. Information on their RA disease activity and their medication was taken before they got pregnant, during pregnancy and up to six months after giving birth. Patients were treated with during pregnancy with prednisone (Deltasone), sulfasalazine (Sulfazine), both of these, or no medication at all.

The results showed that only 14.8% of patients had similar disease activity during the two pregnancies. Disease activity following the first birth, however, predicted disease activity after the second. 63% of patients experienced a flare-up of sympotoms following both births.

The study concluded that there is no trend in RA disease activity in patients from one pregnancy to the next. However, disease activity after giving birth seems to predict the same outcome after further pregnancies. 

This was a relatively small study. The study should be repeated to see if the results can be generalized to a larger population.