Half of the women did physiotherapy or exercise during pregnancy.
A flare
of AS within 6 months of having their baby was experienced by almost
6 in 10 women and occurred more in the women who had active disease
at conception.
The arthritis
in the hands, feet, knees and non-spine joints and occurrence of iritis
was less during pregnancy and worse 6 months after delivery.
In 9 in
10 cases the baby was carried to full term and in 7 in 10 cases was
born naturally. Cesarean section was performed in 3 in 10 cases. In
general Cesarean sections are performed in 12% of pregnancies (1 person
in 10) in Europe and 14%-24% (1-2 people in 10) in USA .
There were
190 boys and 181 girls (51% boys) and 3 still births. 98 in 100
children were healthy and the average birth weight was 3.3 Kg or over
7 lb.
Women who
took NSAID's (i.e. anti-inflammatory drugs) had babies who were as healthy
and of similar weight to those who did not take NSAID's. [However,
most doctors would recommend not taking NSAIDS in the last 6 weeks of
pregnancy as there is a chance of the drug causing problems with the
babies lungs]
More than
half (6½ people in 10) experienced problems caring for a baby
or toddler. This included lifting, carrying and bathing the baby/toddler. Help
from a third person was needed for 3 in 10 couples. The women who had
a flare after birth reported more difficulties than women who did not
flare.
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In
summary : Pregnancy has no major effect on ankylosing
spondylitis symptoms except for iritis and non-spinal arthritis. In
both these, people felt less symptoms when pregnant.
Women with
ankylosing spondylitis in general have healthy babies and they carry
them to full term. There was no difference in the rate of natural abortion
or still birth than would be expected in women without ankylosing spondylitis. However,
Cesarean section was performed more often than among women without AS. AS
was reported as the reason for caesarean section in 6 in 10 cases.
Women who
had active disease before pregnancy were more likely to have a flare
after the birth of their child.
Difficulty
in caring for the baby was reported in more than half of mothers (6.5
in 10). Activities involving the lower back (lifting, bathing the baby)
were the most difficult.
Non-steroidal
anti-inflammatory drugs [NSAID's] do not affect a person's ability to
conceive a baby but there has been a very recent report that taking
NSAIDS around the time of conception of a baby could increase the risk
of miscarriage. For example in recent report, showed that women not
taking NSAIDS had a 15 in 100 chance of a miscarriage and women taking
NSAIDS had a 25 in 100 chance of a miscarriage.
In addition, NSAID's should be avoided in the last 6 weeks of pregnancy
as there is a risk of the baby having bleeding and it can affect the
lungs in babies who are almost ready to be born. Before the baby is
born the heart has a small hole so that blood does not go into the lungs
before the baby starts to breath air. When the baby is born this hole
closes. Taking NSAIDs in the last 6 weeks of pregnancy can cause this
hole to close before the baby is born. This means blood goes to the
lungs too early and this can cause problems with breathing when the
baby is born.
The majority
of steroids are completely safe during pregnancy. [In fact pregnant
women with a risk of a pre-term baby are often give steroids to help
the babies lungs mature]. Therefore, injections of steroids into joints
are safe.
Sulfasalazine
may be taken during pregnancy and there has been no reports of babies
being born with malformations or problems.
Methotrexate
should NOT be taken if a person is trying to get pregnant and it
is suggested that a person should avoid become pregnant within 6 months
of stopping the drug. Methotrexate should NOT be taken during pregnancy.
Men should
not plan to have a baby within 3 months of stopping Methotrexate.
