Rheumatoid arthritis (RA) is an auto-immune disorder that damages the bones and joints of the body, causing chronic pain. Women who are suffering from RA and become pregnant might need to alter their pre-pregnancy treatment regimen for the health and safety of their fetuses.

Nonsteroidal Anti-Inflammatory Drugs

Most nonsteroidal anti-inflammatory drugs (NSAIDs) are Category B drugs, which are drugs used frequently in pregnancy that do not appear to cause major birth defects. NSAIDs treat the symptoms of RA and reduce inflammation that causes discomfort. Ibuprofen and Celebrex are examples of NSAIDs used to treat RA.

Corticosteroids

Also commonly referred to as steroids, these medications also are Category B drugs and are considered safe for use during pregnancy. Since long-term use can result in undesirable side effects, they are recommended for only a short time in order to ease inflammation associated with RA. Prednisone and hydrocortisone are types of corticosteroids.

Disease-Modifying Antirheumatic Drugs

Disease-modifying anti-rheumatic drugs (DMARDs) are used to treat chronic RA pain. The majority fall into categories C, D, or X and have been known to cause birth defects or even fetal death. Sulfasalazine is one DMARD that is a Category B; it does not increase fetal mortality and can be taken safely during pregnancy.

Time Frame

NSAIDs can be taken safely until the third trimester, but they should be discontinued at that point because of the risk of harm to the fetus. Corticosteroids should be avoided during the first trimester but can be taken during the second and third trimesters.

Warning

No medication used in the treatment of arthritis has been proved completely safe during pregnancy, and any of these medications can have adverse side effects. Discuss the potential risks and long-term effects thoroughly with a health-care professional before deciding if RA medications can help you.

Source:

eMedicine

Medscape