Psoriatic arthritis and pregnancy

Printer-friendly version

The ratio of the number of women and men with PsA varies between studies and between the different subgroups of disease. However in most studies, PsA, like rheumatoid arthritis has been found to affect women more often than men. This female preponderance has lead to an interest on the effect of pregnancy on PsA.

Effect of pregnancy on arthritis

Fewer than 20% of female patients develop arthritis before their first pregnancy. Like rheumatoid arthritis, there is evidence of a hormonal influence on the occurrence of PsA. For most, the time after having a baby and the time during menopause are two common times for developing arthritis and it is possible that hormonal factors at these times may trigger the onset of arthritis. Although the activity of arthritis and psoriasis can be variable during pregnancy, research has shown that in general it seems to improve during pregnancy and flare after the birth (post partum flare) in a similar way to rheumatoid arthritis.

There is no significant increase in miscarriages in women with PsA and no other unusual effects on the baby. Breast feeding is encouraged as in any normal pregnancy.

Medication

Many patients are concerned about the effects of their medications on conception and pregnancy. There are no universal guidelines and medication needs to be tailored to individual needs. The general advice is that most medications used for arthritis during pregnancy are safe, although it is sensible to keep medications to a minimum. Patients should be reassured that if a particular medication does need to be stopped for any reason, there are alternatives.

Both female and male patients with PsA should discuss a planned pregnancy with their rheumatologist, dermatologist or GP so that the best advice about their particular medication is given. This is particularly important for patients on disease modifying therapy. Men with PsA taking sulfasalazine should be aware that the drug may reduce the sperm count, but this is fully reversible on stopping the drug.

Originally article written by Dr S M Jones and published in
Skin ‘n’ Bones Connection 1995 Issue No 5 page 25-26