Introduction
Ankylosing spondylitis (AS) causes the spinal bones to fuse, which affects posture and causes stiffness. Patients suffering from ankylosing spondylitis (AS) present unique challenges during pregnancy. A person with AS must consider carefully how their chronic disease may affect the stages of pregnancy and delivery as they prepare to become parents. They usually have concerns regarding the likelihood of pregnancy, the effect of AS on childbirth, possible flare-ups during pregnancy, and the potential for AS to be passed on to the unborn child. Medical help is necessary to get clarity on the concerns regarding pregnancy with ankylosing spondylitis.
How Does Pregnancy Get Affected by Ankylosing Spondylitis?
Ankylosing spondylitis (AS) during pregnancy can cause discomfort and have an impact on the delivery process. The three primary risks are as follows and are mainly seen during delivery:
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Difficulty With Vaginal Birth: An individual with AS may find it more difficult to give birth naturally, which increases the likelihood that they may require a cesarean section (C-section), in which the baby is delivered surgically.
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Obstacles With Anesthetic Delivery: Administering anesthesia, particularly an epidural anesthesia (a spinal injection), can pose difficulties.
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Limited Neck Movement: People with AS may find it difficult to move their necks, which could be an issue if general anesthesia during delivery requires breathing tubes.
Is Fertility Affected by Ankylosing Spondylitis?
Determining the impact of AS on fertility is challenging due to the often conflicting research on the subject. According to research, both men and women may experience adverse effects on their fertility. But compared to men, women appear to be more susceptible. Most research has shown that ankylosing spondylitis does not affect male fertility. Studies have examined how the illness impacts ovarian reserves in women, which is the phrase used to characterize the ovaries' capacity to produce healthy and viable eggs to result in a full-term pregnancy. According to one study, some individuals with ankylosing spondylitis who want to get pregnant after the illness starts may produce less viable eggs from their ovaries.
Does Pregnancy Worsen Symptoms of Ankylosing Spondylitis (AS)?
The weight of an individual increases during the nine months of pregnancy as the baby grows. This severely strains their body, especially the back, muscles, and joints. During the second and third trimesters, the symptoms of Ankylosing Spondylitis (AS), including pain, edema, and stiffness, may worsen. There may be flare-ups of AS symptoms during pregnancy. According to one study, as much as 80 percent of individuals with AS had flare-ups during this time. For most people, the symptoms usually get worse after birth.
How Does an Individual With Ankylosing Spondylitis Plan Pregnancy?
Regarding the planning of a pregnancy with ankylosing spondylitis (AS), there is not any conclusive proof that the illness has an impact on conception. But it is essential to make advance plans. It is advised to take effective birth control until one is ready to become a parent. There are several birth control options available, and some are more effective than others at preventing pregnancy, such as IUDs (intrauterine devices).
Having an early conversation about family planning with a rheumatologist is crucial. This conversation should occur early in the process, not just when the person is prepared to begin trying for a child. The rheumatologist can advise them, particularly if they are taking drugs that must be stopped before becoming pregnant or if it is unknown how a specific prescription will affect them while pregnant. The majority of drugs taken for AS do not pose a risk to fetal development as long as they are removed from the patient's system. This includes over-the-counter medications such as NSAIDs (Ibuprofen, Naproxen, Celecoxib, and more). It is important to talk to the doctor about which medications are safe to use while pregnant.
Autoimmune illnesses like AS have a genetic component, so there is a chance the child will inherit it. Nonetheless, a large number of mothers with autoimmune disorders give birth to healthy, non-autoimmune children. The course of AS is unlikely to be considerably affected by pregnancy alone. Studies show that during the majority of pregnancy, women with AS often experience low and consistent disease activity, peaking in the second trimester.
Is It Advisable to Continue the Medications for Ankylosing Spondylitis During Pregnancy?
A patient's doctor will likely advise continuing medication during pregnancy if it is being used to treat a medical condition at the time of conception and the medicine is safe to use during pregnancy. Ankylosing spondylitis (AS) may affect birth if the mother has arthritis in the hips or back. If so, the developing infant may experience increased pain in those joints. Talking about this with the obstetrician is important. A vaginal delivery may be difficult in some situations due to hip and spine problems, and the administration of an epidural (a painkiller shot around the spinal cord during delivery) may be impacted by inflammation in the spine. Recent research indicates that premature birth or pre-eclampsia, a dangerous pregnancy complication, is more closely associated with cesarean deliveries in individuals with AS than it is with joint or spine issues.
It is essential to plan for the newborn's care. According to research, women with AS may have a flare-up in the months following childbirth, thus necessitating additional assistance with baby care. Extra support is typically required because fatigue may be more than usual, even in cases of well-controlled illness. There is no proof that AS lowers milk production when nursing. Nonetheless, some mothers may experience discomfort when holding their infants to nurse, especially if AS is poorly managed. Certain drugs can transfer to the child, even though AS cannot be transferred through nursing. A lot of drugs are usually safe to use while nursing, and they often pass into breast milk with no difficulty.
Can Women With AS Expect a Healthy Delivery and Baby?
The majority of women with AS give birth to a healthy child. A woman must contact the rheumatologist if the symptoms get worse. This is due to the increased likelihood of a flare-up in the months following childbirth. In medicine and nursing, a woman should inform the doctor to switch medications after giving birth. While many drugs are safe to take while nursing, not all of them are. While caring for the infant is vital, the woman must also look after herself. This entails taking the medications as prescribed, eating properly, sleeping when the baby rests, and receiving assistance from the family, friends, and spouse. Taking care of oneself now will ensure that one can continue caring for her child.
Conclusion
Ankylosing spondylitis is a disorder that results in the fusion of spine bones, producing pain in the joints and lower back. It may make getting pregnant more difficult, but it usually has little effect on fertility. The actual process of pregnancy is usually unaffected, but giving birth may present difficulties, raising the risk of a C-section and creating anesthesia-related problems. Someone with ankylosing spondylitis needs to find out the safest approach to manage their illness without taking risky medications while pregnant by speaking with their doctor as soon as they find out.
