Rheumatoid Arthritis: Pregnancy

Key points

• Rheumatoid arthritis (RA) typically develops in women of a reproductive age. Issues surrounding conception are therefore commonly encountered.
• patients with early or poorly controlled RA should be advised to defer conception until their disease is more stable
• RA symptoms tend to improve in pregnancy but only resolve in a small minority. Patients tend to have a flare following delivery
• methotrexate is not safe in pregnancy and needs to be stopped at least 3 months before conception
• leflunomide is not safe in pregnancy