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Maternal and fetal complications in rheumatoid arthritis pregnancies

Rheumatoid arthritis can impact maternal and fetal health during pregnancy. This article discusses the complications associated with RA pregnancies, including preterm delivery, preeclampsia, infections, and adverse effects of medications by ikecohen
Estimated reading time: 3 min 30 sec
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Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects around 1% of the population. It is characterized by inflammation of the joints, which can lead to pain, stiffness, and swelling.

RA can also affect other parts of the body, including the lungs, heart, and eyes. Women with RA who become pregnant face additional challenges, as the disease can impact maternal and fetal health. In this article, we will discuss the maternal and fetal complications associated with RA pregnancies.

Maternal Complications

Increased Risk of Miscarriage

Women with RA have a higher risk of miscarriage than women without the disease. A study found that the risk of early miscarriage (before 12 weeks gestation) was 30% higher in women with RA compared to those without the disease.

The exact reason for this increased risk is not known, but it is thought to be related to inflammation in the uterus.

Preterm Delivery

Women with RA have an increased risk of preterm delivery, which is defined as giving birth before 37 weeks gestation. A study found that women with RA had a 1.5-fold increased risk of preterm delivery compared to women without the disease.

Preterm delivery can lead to a range of health problems for the infant, including respiratory distress syndrome, jaundice, and developmental delays.

Preeclampsia

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and damage to organs such as the liver and kidneys. Women with RA have an increased risk of developing preeclampsia compared to women without the disease.

A study found that the risk of preeclampsia was 2.5-fold higher in women with RA compared to those without the disease.

Infections

Women with RA are more susceptible to infections, which can have serious consequences during pregnancy. Infections such as urinary tract infections and pneumonia can increase the risk of preterm delivery and other complications.

Pregnant women with RA should take extra precautions to avoid infections, such as washing their hands frequently and avoiding contact with sick individuals.

Maternal Medications

Women with RA often take medications to manage their symptoms, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). Some of these medications can have adverse effects on maternal and fetal health.

Related Article Risks of RA medication during pregnancy Risks of RA medication during pregnancy

For example, NSAIDs can increase the risk of bleeding and premature closure of the fetal ductus arteriosus. DMARDs can cross the placenta and affect fetal development. Pregnant women with RA should work closely with their healthcare providers to manage their symptoms while minimizing risks to themselves and their unborn child.

Fetal Complications

Intrauterine Growth Restriction

Intrauterine growth restriction (IUGR) is a condition in which the fetus does not grow properly in the womb. Women with RA have an increased risk of IUGR compared to women without the disease.

A study found that the risk of IUGR was 2.9-fold higher in pregnancies complicated by RA compared to those without the disease.

Preterm Birth

As mentioned earlier, women with RA have an increased risk of preterm delivery. Preterm birth can lead to a range of health problems for the infant, including respiratory distress syndrome and developmental delays.

Neonatal Hypogammaglobulinemia

Neonatal hypogammaglobulinemia is a condition in which the infant has low levels of immunoglobulin in their blood, which can increase their risk of infections.

A study found that infants born to mothers with RA had lower levels of immunoglobulin compared to infants born to mothers without the disease.

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is a type of arthritis that affects children. Studies have found that children born to mothers with RA have an increased risk of developing JIA compared to those born to mothers without the disease.

The exact reason for this increased risk is not known, but it is thought to be related to maternal antibodies crossing the placenta and affecting fetal development.

Conclusion

Women with RA who become pregnant face additional challenges, as the disease can impact maternal and fetal health.

Maternal complications include an increased risk of miscarriage, preterm delivery, preeclampsia, infections, and adverse effects of medications. Fetal complications include intrauterine growth restriction, preterm birth, neonatal hypogammaglobulinemia, and an increased risk of JIA.

Pregnant women with RA should work closely with their healthcare providers to manage their symptoms while minimizing risks to themselves and their unborn child.

Disclaimer: This article serves as general information and should not be considered medical advice. Consult a healthcare professional for personalized guidance. Individual circumstances may vary.

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