Juvenile Rheumatoid Arthritis and pregnancy

[Everlore]

I'm currently about twelve weeks pregnant with my first baby. I was diagnosed with juvenile rheumatoid arthritis when I was three though had been experiencing symptoms of related uveitis since I was less than a year old.
Things were very rough in my childhood and teens with multiple flare-ups and extended stays in hospital. I responded very badly to most RA medication with high dose steroids being the only drug that ever really eased my symptoms. Since my early twenties I have been on biological drugs which have improved my health and quality of life significantly. Not only have I not had a rheumatoid flare for years but I also find the side effects minimal and very managable.
I have an excellent rheumatologist who has been very supportive of my plans to conceive and has given me good advice and reassurance as to managing my condition and medication in pregnancy. I've been taking 150 mg of aspirin a day to mitigate risks of blood clots, as prescribed by my GP on the reccomendation of my specialist as well as extra calcium, high dose folic acid, iron and usual pregnancy multivitamins. My rheumatologist has advised me that my RA medication is safe to take for the first two trimesters at least, I just have to decide whether I want to take it in later pregnancy as it would mean that baby's vaccinations would have to be delayed until they were six months old. I also take small doses of cocodamol each day to manage my pain, which again I have been advised is ok for the first two trimesters. I'm feeling ok so far, though I imagine this may change as my pregnancy progresses and the extra weight puts more strain on my joints, but I'll cross that bridge when I come to it.
I was just wondering if there were any other mums on here with RA who can give me any advice as to things to watch out for or be wary of during pregnancy. I know it is common for women with RA to go into remission during pregnancy but, since my symptoms were under control before conception I'm not sure if I would notice this. Thanks for your help.

Hi Everlore,

Congratulations on your pregnancy.
I was diagnosed with RA at 29 after already having two kids, both my pregnancies were fairly uneventful (bad morning sickness) and the babies had IUGR so were delivered early but both happy healthy babies.
I am now 9weeks pregnant again at 37, in the last year Iv had an early miscarriage in Nov then a ruptured ectopic in Feb.
I went rogue and came off my biologics in November, I was on adalimumab injections and so far all has been well.
I feel a bit frustrated with my midwife, she listed it under a joint disorder on my booking and hasn't listed me for consultant care, which does worry me.
From the reading I have done so far the most likely flare time is a few weeks postpartum.

Thanks so much for your reply and for sharing your experience. I am sorry for your recent losses but congratulations on your pregnancy, I hope all goes really well for you.
I am sorry your midwife didn't seem to be aware of how to deal with your condition. I had a great experience in my first midwife appointment. She went through my condition, medication and medical history thoroughly and listed my pregnancy as high-risk due to the RA without me needing to do so. Within hours I also had a referal to the lupus in pregnancy clinic, which I believe covers many immune conditions, which I didn't even know she was going to do but was very glad about. The midwife also refered me to a specialist midwife who works with mums with disabilities since I have been completely blind since I was a baby due to uveitis which is related to the JRA.
My rheumatologist and GP have also been great and have cooperated with each other and with the midwife team, it's been true joined-up care. I really think you should speak to the midwife about properly registering your condition so you can be refered to the correct teams and be offered extra screening if necessary. Best of luck with everything!