Pregnancy and Arthritis.

Last updated Tuesday, January 04, 2005

Common questions

Will arthritis go away during pregnancy?

Rheumatoid arthritis may improve at any time during pregnancy. In most women, it usually improves by the end of the fourth month. While joint swelling may decrease, pregnancy women may still have some joint pain or stiffness due to existing joint damage.

Lupus may stay the same, improve, or flare (get worse) during pregnancy. To decrease the chances of a flare, the lupus should be in remission for six months before you become pregnant. This means not only that you feel well, but that blood tests and other tests for the disease are also normal.

Research on scleroderma and other types of arthritis is not as conclusive. Some studies report that scleroderma flares, while others report that it improves.

If illness does improve during pregnancy, it may flare two to eight weeks after your baby is born. Proper planning and treatment before, during and after pregnancy, however, can help decrease pain and swelling and help improve your ability to function. You and your health care team can work together on ways to do this.

Having an abortion will NOT prevent a flare. Any type of delivery--whether from a spontaneous abortion, a therapeutic abortion, or a stillbirth--could cause a flare.

Will a child inherit arthritis?

Probably not. While the causes of most forms of arthritis are not known, some forms tend to appear in families more often than others. These types of arthritis are called "familial", yet heredity is never the single factor that determines if a person develops arthritis. Other factors, such as the environment (exposure to certain viruses or chemicals) also may have an effect.

Scientists have found certain genetic markers that may indicate if some people have a higher risk for getting some types of arthritis. However, the relationship between these markers and the actual development of arthritis is still unclear and does not mean you will pass arthritis on to your child. Generally, there is no way to tell if your child will ever have arthritis in the future.

How does arthritis affect pregnancy?

The physical changes that normally occur during pregnancy may affect joints and muscles in the following ways.

1. Joints may become looser and less stable. This may cause a pregnan woman to "waddle" when she walks.
2. Knee problems may become worse due to increased weight, or because the muscles along the side of the knee become weaker. This might cause knee pain, especially while going up or down stairs or when straightening the knee.
3. As the uterus grows, your spine curves slightly to support it. This can lead to muscle spasms in the back. Sometimes this can also cause pain, numbness and tingling in the legs.
4. Much more blood flows through the body during pregnancy, so it is important that the heart is functioning normally. If your heart is functioning normally, there shouldn't be any problems. If you have any heart problems such as pericarditis (inflammation of the sac surrounding the heart) or myocardltis (inflammation of the heart muscle) your doctor may ask you to delay pregnancy until these problems are under control.
5. Water weight gain may increase stiffness, especially in weight-bearing joints (hips, knees, ankles, and feet). It may also cause problems with carpal tunnel syndrome--a condition that causes pain, numbness, and tingling in the thumb, index, and middle finger. This usually goes away after delivery. Report all water gain to your obstetrician during your office visit. Report any unusual water gain beyond the lower legs, such as in the thighs or face to your doctor right away.
6. Breathing: The breathing muscles will move upward due to the growing baby. This may cause only mild shortness of breath. If you have significant shortness of breath or a change in your breathing, contact your doctor right away.

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