Pregnancy and Autoimmune Disorders

After my last pregnancy (2006) I developed some kind of autoimmune disorder that affected my joints and has been tentatively diagnosed as Undiff. Spondylitis./AS or possibly seronegative RA. I've been on plaquenil for 4 years with great success and tramadol for pain management.
I am now pregnant again and have gone off of plaquenil entirely and have reduced the tramadol intending to discontinue that as well.
My question is concerning remission during pregnancy. If I do NOT go into remission during pregnancy am I doing more damage by staying off the plaquenil? And is there *any* chance that this pregnancy could get rid of the autoimmune disorder altogether?

[Garth L Nicolson, PhD]

It has always interested me that the anti-malarial (antimicrobial) drug plaquenil is effective in many cases of RA and Ankylosing Spondylitis.  

If RA and AS are caused by or affected by chronic infections, then you might expect such results.  Interestingly, the Road Back Foundation (a RA support foundation, www.roadback.org) has for some time suggested that RA and associated diseases are caused by microorganisms that stimulate an inflammatory immune response in the synovia and joints.

Also interesting is the observation that many patients undergo remission during pregnancy but slowly revert again after the pregnancy is over.  During pregnancy a women's immune system is under more control, probably to prevent an immune response against the fetus.  This may explain the apparent remission of RA and other autoimmune diseases during pregnancy.

As to the question about whether pregnancy could eliminate the autoimmune disorder, I strongly doubt this notion.  As mentioned above, in most cases the autoimmune disorder slowly returns after the pregnancy ends.

Prof. Garth Nicolson