Safest Rheumatoid Arthritis Drugs During Pregnancy

Safest RA drugs during pregnancy

None of thedrugsused in the treatment ofrheumatoid arthritis(RA) is completely safe duringpregnancy. You must discuss with your physician the decision to use, modify, or stop any medications.

Paincontrol duringpregnancymay be done through nonpharmacologic management such as paraffin baths, decreased physical activity, splinting, andcoldpacks as adjunctive care.

Corticosteroids:They are considered relatively safe in pregnancy when used in low doses and are designated as category B medications. Category B drugs are those which have been found to be safe inpregnantanimals although they lack adequate studies in pregnant women. Corticosteroids have potent anti-inflammatory action. They may, however, increase the maternal risk ofhigh blood pressure, swelling, increased sugars during pregnancy, poor bone health in pregnancy, premature delivery, low birth weightbabies, and birth defects such ascleft palatein thenewborn. Certain corticosteroids such asprednisoneand hydrocortisone are safer for use without adverse events in the fetus.

Sulfasalazine:It is another important medication forRA. It is also a category B medication. Sulfasalazine does not put the developing baby at risk and is considered safe in pregnancy.

Hydroxychloroquineor HCQ: HCQ is considered safe during pregnancy. It is a category C medication, which means that animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may permit the use of the drug in pregnant women.

Tumor necrosis factor (TNF)-alpha antagonists: These are commonly used inRAmanagement. They belong to category B and are considered safe during pregnancy.

某些其他drugs such asazathioprineandabataceptare used in the treatment ofRAin pregnant women only if the risks of side effects are outweighed by the benefits of these drugs. These drugs have been found to cause fetal defects in a few studies.

Hence, the ultimate decision to use a certain drug should be made only in consultation with the doctor.

Most studies on RA suggest that RA does not increase the overall risk for amiscarriage. Some researchers suggest that both disease activity and certain RA medications may have a role in causing miscarriage in some women such as those with severe diseases.

Generally, delivery by cesarean delivery does not appear to be performed more commonly in patients withrheumatoid arthritis(RA). Any pregnancy, with or without RA, may be associated with factors that demand the baby to be delivered by cesarean delivery.

None of the studies done so far conclusively say that RA mandates or increases the chance of cesarean delivery. In some women with RA, who have severe disease, the need for cesarean delivery may be higher than in other women.

Becauserheumatoid arthritis(RA) affects the joints, it is important to eat right during pregnancy.

• There should not be excessweight gainin pregnancy.
• At the same time, the mother and baby’s nutritional needs should not be compromised.
• Pregnant women with RA are advised to have a low-fat, high-carbohydrate, and high-fiberdiet. This includes
  • adietrich in vegetables,
  • fruits,
  • nuts,
  • mushrooms, and
  • salmon.
• They should avoid fried and grilled foods, pastries, pasta, and other processed foods.
• They can have fish oils in moderate quantities during pregnancy only after consulting their doctor.
• Pregnant women with RA should avoidover-the-counter(OTC) herbal remedies andsupplements.
• They should take routine oral calcium andvitamin Dsupplementsas advised by their doctor.