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Getting Pregnant With Ankylosing Spondylitis

If you have ankylosing spondylitis, you are likely to need additional support during your pregnancy, delivery, and postpartum period. There is very little research into women with AS and their pregnancies, but here is what we do know.

Unlike other autoimmune conditions like rheumatoid arthritis, ankylosing spondylitis (AS) does not generally improve during pregnancy. In fact, a 1998 study found that women with AS had an equal chance of having their disease improve, worsen or stay the same during their pregnancy. However, women with the subtype of peripheral spondyloarthritis (arthritis in joints away from the spine) were more likely to experience remission during pregnancy.1,2

A 2005 study found that women with AS had the most increased pain and reduction in quality of life during pregnancy, compared to those with rheumatoid arthritis or women who were otherwise healthy. However, this seemed to have no impact on the women’s mental and emotional health, which tended to remain positive.3

Your baby and AS

The good news is that AS is unlikely to affect your fertility or your baby, though the chance of your child developing AS later in life is slightly increased.2,4

Labor and delivery

AS will very likely affect your labor and delivery. That’s because spinal inflammation or fusion, both hallmarks of AS, may make it difficult to spread your legs wide or receive an epidural.

An epidural is the most common method of pain relief during vaginal and Caesarean (C-section) delivery. But it may be difficult or inadvisable for a doctor to give you an epidural because it requires pain medication to be injected between your vertebrae directly into the spinal canal.

You should discuss alternative pain-relief methods with your doctor before delivery. C-section deliveries are often a necessity for mothers with AS and if an epidural can’t be used, general anesthesia may be required.

Postpartum

It appears that if you are in the middle of a flare when you become pregnant, you are more likely to flare shortly after delivering your baby. Up to 60 percent of women flare after delivery.1

If you are thinking about becoming pregnant or are already pregnant, it is important to talk to your doctor about your concerns and any special needs you may have as you manage pregnancy and AS.

Written by: Jessica Johns Pool | Last reviewed: March 2019
  1. Arthritis Foundation. Ankylosing Spondylitis and Pregnancy. Available at https://www.arthritis.org/living-with-arthritis/life-stages/pregnancy-family/pregnancy-and-ankylosing-spondylitis.php. Accessed 3/13/2019.
  2. Husby G, Ostensen M, Gran JT. Ankylosing spondylitis and pregnancy. Clin Exp Rheumatol. 1988 Apr-Jun;6(2):165-7.
  3. Förger F, Østensen M, Schumacher A, Villiger PM. Impact of pregnancy on health related quality of life evaluated prospectively in pregnant women with rheumatic diseases by the SF-36 health survey. Ann Rheum Dis. 2005 Oct;64(10):1494-9. Epub 2005 Mar 18. DOI: 10.1136/ard.2004.033019.
  4. Giovannopoulou E, Gkasdaris G, Kapetanakis S, Kontomanolis E. Ankylosing Spondylitis and Pregnancy: A Literature Review. Curr Rheumatol Rev. 2017;13(3):162-169. doi: 10.2174/1573397113666170317114857.