Methotrexate Pregnancy Impact: Examining Potential Risks and Precautions
Methotrexate, a drug commonly used to manage symptoms of rheumatoid arthritis (RA), poses a significant risk to unborn babies if taken during pregnancy. The Food and Drug Administration (FDA) strongly advises against the use of methotrexate during pregnancy, especially for non-cancer indications.
The potential adverse outcomes of methotrexate exposure during pregnancy include major birth defects, increased risk of miscarriage, fetal death, and intrauterine growth restriction. Malformations affecting the craniofacial region, cardiovascular system, central nervous system, and extremities have been observed in about 6.6% of live births in women exposed to low-dose methotrexate (less than 30 mg/week), which is higher than in patients treated with other drugs[1].
Rates of spontaneous abortions are reported to be around 42.5% in pregnant women exposed to methotrexate, compared to 22.5% in patients treated with other medications[1]. Furthermore, fetal death and intrauterine growth restriction are documented risks[1][2][4].
To prevent pregnancy-related complications, women who are taking methotrexate are advised to avoid pregnancy during treatment and for at least 3 to 6 months after stopping the drug. Reliable contraception is strongly recommended during this period to prevent pregnancy due to the potential teratogenic effects[1][3][5].
Men should also avoid taking methotrexate when trying for a baby. Methotrexate can affect the fetus if either parent has been taking it. To avoid unplanned pregnancies, people can use effective forms of birth control such as condoms, the birth control pill, and intrauterine devices (IUDs).
For individuals with RA who are planning a pregnancy, prepregnancy counseling and ongoing communication with their obstetrics/gynecology doctors for all reproductive health issues are highly recommended. A doctor can offer advice about alternative RA medications to take during pregnancy, such as azathioprine, hydroxychloroquine, sulfasalazine, corticosteroids at low doses, and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs).
It is essential to remember that all medication has the potential to cause side effects, and people should discuss their options with a trained healthcare professional. If someone who can become pregnant is taking methotrexate and suspects that they are pregnant, they should take a pregnancy test as soon as possible and stop taking methotrexate if the test is positive.
In cases of ectopic pregnancies, methotrexate injections can be used to treat the condition by interrupting the growth and division of a fertilized egg. Symptoms of an ectopic pregnancy include vaginal bleeding or spotting, cramping or abdominal pain, nausea, and skin sensitivity. If you experience these symptoms, seek immediate medical attention.
In conclusion, methotrexate exposure during pregnancy can cause serious congenital abnormalities and a high risk of miscarriage and fetal death. It is crucial to avoid pregnancy while on methotrexate and for several months afterward to ensure the health and safety of the unborn child.
- Pregnant women are strongly advised to avoid methotrexate, a drug commonly used for rheumatoid arthritis, due to the increased risk of birth defects, miscarriage, fetal death, and growth restrictions.
- To prevent pregnancy-related complications, women taking methotrexate should avoid pregnancy during treatment and for at least 3 to 6 months after stopping the drug, and rely on reliable contraception during this period.
- Men should also avoid taking methotrexate when trying for a baby as the drug can affect the fetus if either parent is taking it.
- For individuals with rheumatoid arthritis planning a pregnancy, prepregnancy counseling and communication with obstetrics/gynecology doctors for all reproductive health issues are recommended.
- In cases of ectopic pregnancies, methotrexate injections can be used to treat the condition by interrupting the growth and division of a fertilized egg.
- It's essential to remember that all medication has the potential to cause side effects, and people should discuss their options with a trained healthcare professional before taking any medication.
- Methotrexate is a drug used to manage symptoms of rheumatoid arthritis, but it poses a significant risk to unborn babies during pregnancy, especially for non-cancer indications.
- To ensure the health and safety of the unborn child, it is crucial to avoid pregnancy while on methotrexate and for several months afterward, and to consult with health and wellness professionals regarding medical-conditions, chronic-diseases, mental-health, men's health, and women's health during pregnancy.
