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Pregnancy in
Fibromyalgia
Robert Bennett MD
Fibromyalgia
patients appear to have normal fertility; according to the NFA
survey of nearly 3,000 patients the following relevant data were
collected:
|
Currently married |
64.2% |
|
Never married |
11.2 |
|
No children |
26.5% |
|
One child |
16.5% |
|
Two children |
30.5% |
|
More than 3 children |
20.9% |
These figures
compare very favorably with the National Census Bureau figure of
2.1 children per woman.
Medications
and pregnancy
Most FM
patients are using medications which may
harm the
developing fetus; as a general rule it is best to stop all
medications when your are trying to conceive. However, some
medications are safe to take during pregancy; these are
classified by the FDA as class A drugs. In general
antidepressant drugs, NSAIDs and acetaminophen are safe to use
during pregnancy. Importantly
alcohol,
tobacco and most
illicit drugs (e.g. heroin, cocaine) are harmful to the
developing fetus. You should always discuss your medications
with your doctor and also do some research and reading yourself.
All package
inserts have the following FDA classification classification of
drug interactions with pregnancy:
|
CATEGORY |
DESCRIPTION |
|
A |
These drugs are the safest. Well-designed studies
in people show no risks to the fetus. |
|
B |
Studies in animals show no risk to the fetus, and no
well-designed studies in people have been done.
OR Studies in animals show a risk to the fetus, but
well-designed studies in people do not. |
|
C
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No adequate studies in animals or people have been
done.
OR In animal studies, use of the drug resulted in
harm to the fetus, but no information about how the
drug affects the human fetus is available. |
|
D
|
Evidence shows a risk to the human fetus, but
benefits of the drug may outweigh risks in certain
situations. For example, the mother may have a
life-threatening disorder or a serious disorder that
cannot be treated with safer drugs. |
|
X |
Risk to the fetus has been proved to outweigh any
possible benefit. |
The experience of pregnancy is quite variable in fibromyalgia
patients; I have personally cared for 3 patients who experienced
an almost complete remission of their fibromyalgia for some 6-8
months after giving birth. However, even in completely healthy
woman the increasing weight and changes in the center of gravity
that ensue as the pregnancy progresses place extra demands on
the skeleton and muscles which often cause back
pain and
aggravation of FM symptoms. Also see
Pregnancy Study from Scandinavia
Karen Schaefer
provides some very useful guidelines for
managing pregnancy in FM patients.
Also see
General Advice
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