Question
When me and my husband want to start our family, how will my rheumatoid arthritis affect my pregnancies would you recommend to adopt or would it be ok to try and have them ourselves?
Answer
It is difficult to answer fully without knowing more about your RA. One of the biggest problems is that many of the medications used for RA need to be stopped during pregnancy (acutally before attempting pregnancy) because of concerns about their effects on the developing fetus. Drugs such as methotrexate, leflunomide, NSAIDs need to stopped. Low doses of prednisone, plaquenil and sulfasalazine can be continued. The use of TNF inhibitors is unknown in pregnancy, but many doctors recommend stopping either before or when pregnancy is known. When stoppng medications, many patients will experience a flare of their arthritis. The good news is that many patients will experience an improvement in the second and third trimesters. Discuss pregnancy with your rheumatologist. Many patients have had successful pregnancies.
