Rheumatologist Questions Sacroiliitis

My sister is suffering from sacroiliitis. Will it affect her chances of getting pregnant?

My sister is suffering from sacroiliitis for the last 7 months. She has intense pain in her joints due to this. Will it affect her chances of getting pregnant in the future as she is wanting to start her family soon.

8 Answers

sacroiliitis can be related to Ankylosing Spondylitis, Psoriatic arthritis or even Crohns Disease or Ulcerative Colitis
The first thing we need is a diagnosis
Then we can address the question you ask
First of all need to know why she has Sacroiilitis. depends on same and medications can know regarding pregnancy. Please see any Rheumatologist.
Hello!

Any chronic inflammation can affect pregnancy chances. If your sister has Ankylosing Spondylitis, a rheumatologic condition affecting the SI joints, this can also negatively impact pregnancy. Pls consult with a rheumatologist about the correct diagnosis and treatment pathway.

Thanks so much!

Best regards,
Dr Brionez
Hello,

If your sister has been diagnosed with sacroiliitis, it could be indicative of an inflammatory form of arthritis that can affect predominantly but not only the joints in the spine and sacroiliac joints. This form of arthritis is called a spondyloarthropathy. It is a very treatable form of arthritis. There are other reasons people can have sacroiliitis including trauma and injury or even infection. Since we have no information about how was diagnosed, any of these could be possible. It would be appropriate for you sister to be evaluated by a rheumatologist to rule out this type of disease, spondyloarthropathy. This condition can be treated and should not necessarily preclude her from getting pregnant but she should have it evaluated before getting pregnant.

I hope this helps your sister.
There are several possible causes for sacroiliitis. When associated with ankylosing spondylitis, fertility does not seem to be greatly affected, but it may affect other parts of the process. The sacroiliac joints naturally loosen during pregnancy, so symptoms may either increase, decrease, or stay the same. Up to 60% of women with forcing spondylitis flare within six months of delivery. Likewise, women with spondylitis are more frequently delivered by cesarean section.
Well first of all it is important to know whether sacroiliitis is related to spondyloarthropathies, systemic inflammatory arthritis like RA or connective tissue disorders. Are these the only joints involved or she have polyarticular involvement. Some of inflammatory arthritis may get better during pregnancy and others like related to lupus may get worse. Some of medications used to treat inflammatory arthritis may not be used during pregnancy and actually medications like methotrexate or leflunomide can induce abortion. As the pregnancy advances increase in mechanical pressure may worsen lower back or SI joint pain. Recommendation is to control inflammatory arthritis first and once it is in god control then plan for conception. She may need to work with Rheumatologist for better control of her disease and then planned conception. Hope my answer will satisfy you.

Zeeshan Afzal MD.
Consultant Rheumatologist.
She can take several types of meds that will help the pain and inflammation and be safe during pregnancy
I am sorry to hear that your sister is in so much pain. In general it would be best to get the inflammation and pain under control before she gets pregnant. I am not aware of any studies that document decreased fertility related to active sacroilitis. However, there may be complications with the pregnancy and child birth related to active inflammation. There are medications that she can take prior to getting pregnant which are relatively safe in pregnancy. For example Cimzia (a TNF blocking medication like Humira or Enbrel), is highly effective and does not cross the placenta and is not known to adversely effect the baby during pregnancy.
In summary, I highly recommend that she get the disease under control before getting pregnant.