Ankylosing Spondylitis and Pregnancy

Medical Author: William C. Shiel Jr., MD, FACP, FACR

The influence of pregnancy, delivery, and the post-partum period is a common concern of persons with arthritis and related conditions. Although ankylosing spondylitis occurs predominantly in men (two to three times more common in males than in females), women can and do develop the disease.

This topic of pregnancy and ankylosing spondylitis was studied and published under the title "Ankylosing spondylitis--the female aspect" (J Rheumatol 1998 Jan;25[1]:120-4). I think this study serves well as a review of pregnancy issues in women with ankylosing spondylitis.

In collaboration with the Ankylosing Spondylitis International Federation, a questionnaire including clinical data and details on past and recent pregnancies was sent to the female members of national and regional Ankylosing Spondylitis societies in the USA, Canada, and 11 European countries. (It should be noted that questionnaires do have shortcomings from a research standpoint, including inaccurate completion of the forms, lack of personal interaction, and accurate interpretation of both the questions and the responses.)

Nine hundred thirty-nine questionnaires were completed. The researchers found that the average age of the responding women at the onset of their ankylosing spondylitis was 23 years. In 21% of these women, the onset was related to a pregnancy, either occurring during or immediately after the pregnancy.

In this group, the frequency of accompanying features of ankylosing spondylitis was as follows: 45% had inflamed joints away from the spine (peripheral arthritis); 48% had inflammation of the iris of the eye (acute anterior uveitis); 18% had psoriasis; and 16% had inflammatory bowel disease.