Pregnancy and rheumatoid disease

The onset of pregnancy appears to result in the amelioration of rheumatoid disease activity. This is most likely to be related to the change in hormonal, and thus immunological, status of the mother. Spontaneous abortion appears to be increased in mothers with rheumatoid disease. Whether this is due to disease status or to drug therapy is not entirely clear for all cases, but there is a suggestion that it could be the disease state. If at all possible, drugs should be avoided during pregnancy but simple anti-inflammatory drugs in low dosage probably do not produce any major problems. Immunosuppressant drugs should be avoided at all times except when the mother's health is at serious risk. The continued use of disease remitting agents throughout pregnancy is probably not necessary and there is still sufficient question as to whether these drugs could be potentially toxic to the infant. Primum non nocere.