What to Know About Psoriatic Arthritis and Pregnancy

• June 3, 2024
• Dr Peter Landsberg

Last updated on April 23, 2024

Psoriatic arthritis, a chronic autoimmune condition, adds an extra layer of complexity for individuals navigating the journey of pregnancy. Balancing the needs of both the growing baby and the mother’s health to support positive pregnancy outcomes requires careful consideration and management.

In this article, we explore the unique challenges and considerations associated with psoriatic arthritis and pregnancy, providing insights into how women can maintain their well-being and ensure a healthy journey.

What is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is a type of inflammatory arthritis that affects individuals with psoriasis, a chronic skin condition characterised by red, scaly patches. PsA can cause joint pain, swelling, and stiffness, often impacting the peripheral joints, spine, and even the entheses (the areas where tendons and ligaments attach to bones). The exact cause of PsA is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

The Challenge of Psoriatic Arthritis and Pregnancy

Pregnancy brings about significant hormonal and physiological changes in a woman’s body. For those with autoimmune diseases like psoriatic arthritis, these changes can have varying effects on the course of the disease and disease severity. While some women may experience an improvement in symptoms and disease activity during pregnancy, others may find that their condition worsens.

Navigating this uncertainty requires a proactive and informed approach to treatment options to ensure the well-being of both mother and baby, including evaluating the effectiveness and safety of systemic medications, monitoring disease activity, and more to support healthy pregnancy outcomes.

Psoriatic Arthritis and Fertility

Impact on Fertility

Psoriatic arthritis itself generally does not affect fertility in women and does not appear to impact sperm quality either. However, some medications used to manage the condition may have implications for conception. It’s important to discuss your treatment plan with your healthcare provider to make informed decisions about medication adjustments.

Effects on Pregnancy

Women with well-controlled psoriatic arthritis can have successful pregnancies and healthy foetal development. However, increases in disease activity or uncontrolled symptoms may pose an increased risk for adverse pregnancy outcomes, including preterm birth and low birth weight. Regular monitoring and collaboration between the rheumatologist and obstetrician are essential to manage the condition throughout pregnancy.

Medication Safety Considerations

Medication Safety

Many women with PsA take medications for autoimmune diseases to manage symptoms. Some PsA medications may need to be adjusted or discontinued to avoid pregnancy complications, while others may be deemed safe. The decision should be made in consultation with both the rheumatologist and obstetrician to balance disease management and foetal safety, supporting healthy pregnancy outcomes in women.

Managing Flares

The fluctuating nature of psoriatic arthritis may lead to flares during pregnancy. It’s important for women and their healthcare team to have a plan in place to manage flares and increased disease activity effectively. In addition to safe PsA medications, physical therapy and joint protection strategies can be explored alongside safe medications.

Lifestyle and Support

Nutrition and Exercise

Proper nutrition and regular, low-impact exercise can support overall well-being and help manage arthritis symptoms to calm disease activity.

Emotional Well-being

Seeking support from healthcare providers, support groups, or mental health professionals can provide coping strategies and alleviate stress to help reduce disease activity and support healthy pregnancy outcomes.

Considerations for Your Postpartum Period

Breastfeeding and Medications

Always discuss the compatibility of PsA medications with breastfeeding with healthcare providers. Some medications may be safe during breastfeeding, while others may need to be adjusted or temporarily discontinued.

Resuming Medications

The postpartum period can trigger disease flares and increased PsA symptoms in many women, so close monitoring and a proactive approach are essential. If you want to resume or adjust medications, always discuss this first with your healthcare providers.

Collaborative Care Between Your Obstetrician & Rheumatologist

• Rheumatologist and Obstetrician Collaboration: A collaborative approach is key to managing this chronic inflammatory disease during pregnancy. This team-based approach helps tailor the treatment plan to the unique needs of each patient and manage any cases where there is increased risk or flare-ups in PsA symptoms.
• Individualised Treatment Plans: Each woman’s experience with psoriatic arthritis during pregnancy is unique, so individualised treatment plans are crucial to healthy pregnancy outcomes.

Want to speak to a rheumatologist in Brisbane? Contact us for compassionate specialist care throughout your pregnancy journey and beyond.

FAQs

Is psoriatic arthritis a high-risk pregnancy?

Having this autoimmune disease doesn’t categorise a pregnancy as high-risk, but certain factors, such as medication use and disease activity, may cause increased risk and require careful management.

Can you get pregnant if you have psoriatic arthritis?

Yes, women with this autoimmune disease can conceive. However, planning with healthcare providers is crucial to discuss medication adjustments, manage potential increased risk during pregnancy and minimise adverse pregnancy outcomes.

What are the increased risks if you are pregnant and have psoriatic arthritis?

You may have an increased risk for preterm birth, low birth weight, and potential complications associated with medication use. Regular monitoring and collaboration between rheumatologists and obstetricians are essential.

Can pregnancy cause flare-ups of psoriatic arthritis?

Pregnancy may affect this autoimmune disease differently for each woman. Some experience improvement, while others may have flare-ups. A proactive management plan is important to support your pregnancy and a healthy baby.

What foods should be avoided with psoriatic arthritis?

While there’s no one-size-fits-all diet, some individuals with psoriatic arthritis may benefit from reducing their intake of processed foods, saturated fats, and sugar. A balanced diet with anti-inflammatory foods like fruits, vegetables, and omega-3 fatty acids may be beneficial.

Are psoriatic arthritis medications safe during pregnancy?

The safety of medications varies, and some medications may be adjusted or discontinued during pregnancy, while others may be deemed safe. It’s best to make this decision with your rheumatologist and obstetrician.