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Pregnancy & Psoriatic Arthritis

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Pregnancy and Psoriatic Arthritis

What is psoriasis and psoriatic arthritis?

Psoriasis is a skin condition in which skin cells grow faster than usual. This can lead to dry, thick patches on the skin. Psoriasis is not contagious, so you cannot catch it from another person. While the exact causes are not known, the immune system is thought to be involved. In addition to changes to the skin, some persons with psoriasis will also develop swollen and painful joints, called psoriatic arthritis (PsA). Symptoms of psoriasis and PsA can range from mild to severe.

I have psoriasis and /or psoriatic arthritis. Can it make it harder for me to get pregnant?

These conditions might affect fertility, although not all studies agree. One study did not find an increase in time to become pregnant among people with mild to moderate psoriasis. However, another study of persons with moderate to severe psoriasis has suggested that ovarian reserve (the number of eggs stored in the ovaries) might be affected by psoriasis. The people with psoriasis in this study were still able to become pregnant. Effects on fertility might depend on whether symptoms are currently mild or severe, or if there are additional health conditions for the person who is pregnant.

Does having psoriasis and/or psoriatic arthritis increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Based on the studies reviewed, it is not known if psoriasis or PsA increases the chance for miscarriage. One study that looked at 298 pregnancies in persons with moderate to severe psoriasis found that the rates of miscarriage did not differ from rates in the general population. Another study found a higher rate of miscarriage after the diagnosis of PsA in 37 pregnancies compared to their pregnancies prior to the diagnosis. However, age at time of pregnancy was higher after the diagnosis of PsA, and as people age, so does the chance for miscarriage. This, plus the small number of pregnancies looked at, does not allow for conclusions regarding miscarriage and PsA.

Does having psoriasis and/or psoriatic arthritis increase the chance of birth defects?

Every pregnancy starts with a 3-5% chance of having a birth defect. This is called the background risk. Studies have not been done to see if psoriasis or PsA increases the chance for birth defects.

Would having psoriasis and/or PsA increase the chance of other pregnancy related problems?

This isn’t clear because some studies have reported a higher chance for pregnancy related problems, but other studies have not.
One study found that people with severe psoriasis were more likely to have a baby with low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), while another study among people with moderate to severe psoriasis found the opposite, that they were more likely to have a baby with a heavier birth weight. Some studies have suggested that psoriasis or PsA increases the chance for preterm delivery (birth before week 37) or pre-eclampsia. Preeclampsia is a serious pregnancy related condition that can cause symptoms such as high blood pressure or fluid retention. Other studies have not reported an increased chance for these pregnancy complications. The chance for pregnancy complications might depend on whether the psoriasis and/or PsA symptoms are currently mild or severe. The chance for pregnancy complications can also be affected by the overall health of the person who is pregnant. For example, a study found a higher rate of smoking, depression, and obesity with persons with psoriasis.

Does having psoriasis and/or psoriatic arthritis in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if psoriasis or PsA can cause behavior or learning issues for the child.

I am taking medication for psoriasis and/or psoriatic arthritis. Can I take my medication during pregnancy?

It is important that you discuss treatment options with your healthcare providers when planning pregnancy, and as soon as you learn that you are pregnant.

How will pregnancy affect my psoriasis and/or PsA symptoms?

Healthcare providers are not able to predict how a person’s symptoms might change, if at all, during pregnancy. People who are pregnant have reported symptoms that improved, stayed the same, or became worse during pregnancy. In general, it appears that more people report that their disease symptoms improve or stay the same rather than get worse during pregnancy. However, a flare up of symptoms after delivery is common.

Breastfeeding while I have psoriasis and/or psoriatic arthritis?

There are no cautions regarding breastfeeding specific to psoriasis or PsA. Be sure to talk to your healthcare provider about your breastfeeding questions.

If a male has psoriasis and /or psoriatic arthritis, can it make it harder to get a partner pregnant or increase the chance of birth defects?

Autoimmune diseases like psoriasis might affect a man’s fertility. Certain medications used to treat psoriasis or PsA could also affect a man’s sperm production. This could make it harder to get a partner pregnant. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy.

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