Methotrexate is an effective rheumatoid arthritis treatment, but women who take it while pregnant or trying to conceive could risk their unborn child’s safety.
The baby was born with just four fingers on each hand.
It wasn’t surprising. Months before, the expectant mother had been exposed a high dosage of methotrexate, a common drug used to treat rheumatoid arthritis that can also cause birth defects. The doctors had anticipated problems with the baby, but when they had to induce labor early because of uterine complications, she came into the world tinier and more defenseless than expected. As she grew, the child would likely develop limb defects, developmental disabilities and joint abnormalities, according to a 2012 article in The Journal of Family Practice.
But this is not a story about the baby, or her parents, or their lives — changed forever because of a combination of chemicals taken at the wrong time. This is a story about other women who ingest methotrexate for years to manage their rheumatoid arthritis and the effect it could have on their families.
“The drugs are potentially dangerous to the baby,” said Sasha Bernatsky, MD, PhD, a rheumatologist at McGill University in Canada. “We counsel women not to be pregnant until they’re off methotrexate, until it’s not in their system because these drugs build up in their system.”
Methotrexate for Rheumatoid Arthritis
Methotrexate is one of the most prescribed disease modifying drugs, and people tend to use it for extended periods of time. Women who are sexually active while on the medication run the risk of getting pregnant and exposing their unborn children to harmful chemicals. Unlike other drugs, such as Accutane, an acne medication, that require women to concurrently practice some form of birth control, there are no such regulations for methotrexate. Unplanned pregnancies while on the medication commonly result in induced abortion, most likely due to the fetal toxicity of the drug, according to a report published this week in the journal Arthritis Care & Research.
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