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.
