What effect does pregnancy have on the spondyloarthropathies

What effect does pregnancy have on the spondyloarthropathies and vice versa?

• Fertility is unaffected.

• The course of ankylosing spondylitis varies during pregnancy (33% improve, 33% worsen) and up to 60% worsen postpartum (mostly low back pain).

• Newer data suggests that women may have increased risk of cesarean section, preterm birth, and infants born small for gestational age.

• Up to 50% of patients with psoriatic arthritis may improve.

• Elevated disease activity and antitumor necrosis factor discontinuation in early pregnancy are associated with increased risk of disease flare later in pregnancy.

• Patients with severe back and/or hip disease should be assessed for their capability to deliver vaginally.

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