If you’ve decided to take the plunge into parenthood, congratulations! It’s a huge decision for any woman, but for a woman living with psoriatic disease there may be questions about what you can do to prepare and increase your chances for a healthy pregnancy.
It’s important to talk with your healthcare providers – both the doctor treating your psoriatic disease as well as your OB/GYN– as soon as you think you’re ready. To help guide you, here are five important questions to ask your healthcare provider before becoming pregnant:
1. What can I do to prepare my body for pregnancy?
Every woman who is planning a pregnancy should avoid drinking alcohol and smoking cigarettes, reduce stress, exercise, eat a healthy diet, and take prenatal vitamins with folic acid. While it may seem overwhelming to make these lifestyle changes, each one of these is very important. In some woman with psoriatic disease, alcohol, cigarettes or stress may trigger a flare or aggravate her disease. Exercising and eating right contributes to maintaining a healthy weight, which can reduce the risk of complications during pregnancy. And taking folic acid supplements before you get pregnant can significantly reduce the chance of major birth defects affecting the baby’s brain and spine.
Alcohol in any quantity at any time in pregnancy can be harmful to the developing baby, and can be especially harmful in the early weeks of pregnancy when a woman may not know she is pregnant. To give your baby the healthiest growing environment possible, it is MotherToBaby’s recommendation that a woman avoid alcohol entirely while trying to conceive and throughout her entire pregnancy. If you think it would be difficult for you to make lifestyle changes such as giving up alcohol, we encourage you to have an honest discussion with your healthcare provider.
2. Is my fertility affected by my disease or the medications I’m taking?
In general, clinical data is very limited on whether certain medications or diseases can affect a woman’s fertility. However, there are no reports linking Humira (adalimumab), Enbrel (etanercept), Remicade (infliximab) with fertility problems.
3. How will pregnancy affect my psoriatic disease? What if I have a flare?
This can be hard to predict, as it varies from person to person and even from pregnancy to pregnancy. Many pregnant women who have psoriasis report that their symptoms spontaneously improve during pregnancy while others report that their symptoms get worse during pregnancy. In addition, inflammatory flares can occur 1-2 weeks after delivery. If your psoriasis symptoms get worse during your pregnancy or after you deliver, be sure to talk with your doctor.
4. Can I safely take the same medications I am taking now when I get pregnant?
Once you decide to begin trying to conceive, it is important to discuss treatment options with your health care provider. Some medications are not safe to take during pregnancy and may require a period of time to clear from the body before conception. The benefits of taking a medication for psoriatic disease need to be weighed against the potential risks.
If you are currently taking methotrexate or Soriatane (acitretin) or if you are using Tazorac (tazarotene), talk to your doctor about switching to different medications as soon as safely possible. Although tazarotene is applied to the skin, there is a concern about possible birth defects. Methotrexate and acitretin, both of which are taken by mouth, are known to increase the chance of birth defects. For acitretin in particular, women must avoid becoming pregnant for at least three years after discontinuing the medication.
Women who require medication to treat psoriatic disease during pregnancy have options depending on the severity of their disease.
5. What about breastfeeding after I have a baby?
It is rarely required that a woman discontinue breastfeeding just to take a medication. For one thing, many medications don’t make their way into breast milk. And even if a medication does pass to the nursing infant, the dose that the infant receives is usually not enough to affect her/him. But if your baby was born early (before 37 weeks), be sure to discuss breastfeeding options with your healthcare provider. Preterm infants may be more susceptible than full-term babies to small amounts of drugs in breastmilk because they may not be able to eliminate drugs well.
Also, be sure to check out MotherToBaby’s NEW fact sheet on psoriasis, pregnancy and breastfeeding.
Driving discovery, creating community
For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.