For some women with RA, pregnancy brings on an unexpected bonus: improved symptoms. Approximately 70% of women with RA experience improved symptoms in the second trimester that can last through the first 6 weeks after delivery, says J. Bruce Smith, MD, assistant compliance officer for research at Thomas Jefferson University in Philadelphia and a rheumatologist whose research has focused largely on autoimmune disease and pregnancy.
There are several theories why disease symptoms improve, including increased anti-inflammatory cytokine levels and hormonal changes that occur during pregnancy. Exactly why some women with RA improve while others don’t is unknown, but a study out of the Netherlands shows that women who are negative for rheumatoid factor and a type of autoantibody called anti-CCP are more likely to improve during pregnancy. Research also suggests that the father’s genetic contribution may play a role. The more genetically similar a baby is to its father, the more improved outlook for the mother’s disease activity.
However, pain-free postpartum bliss can be short-lived. If you’ve experienced milder disease during your pregnancy, there’s a fair chance your disease will worsen again – at least for a while – after you deliver. In a 2008 study out of the Netherlands, 39% of participating RA patients had at least one moderate flare postpartum. You may welcome help from friends and family in the early months, especially if you find yourself having to deal with a flare at the same time you are trying to recuperate from childbirth and adjust to parenthood.
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