Ankylosing Spondylitis

Changes in estrogen and progesterone levels during pregnancy induce a Th2 immune bias, which alleviates symptoms in some autoimmune diseases. However, since the rate of reactivation (flare) within 3 to 6 months after childbirth is high, it is important to resume treatment promptly after delivery. NSAIDs are prohibited during the third trimester of pregnancy (due to the risk of premature closure of the ductus arteriosus), and the use of biological agents in late pregnancy must be adjusted based on whether they cross the placenta. It is the standard recommendation to review medication switching starting 3 to 6 months before planning a pregnancy. Perspective of a Korean Medicine Clinic In Korean medicine, pregnancy is a period when Qi and blood, which are essential for maintaining the pregnancy, are intensively consumed to nourish the fetus; this can place an additional burden on patients with ankylosing spondylitis based on kidney deficiency. During the pregnancy planning stage, it is crucial to establish a foundation for symptom stability during pregnancy by sufficiently replenishing kidney deficiency and eliminating blood stasis and phlegm in advance. Since the scope of herbal medicine prescriptions is limited during pregnancy, the focus shifts to external treatment centered on acupuncture and moxibustion, along with dietary management. Safe management is maintained by centering on acupoints that preserve Qi and blood circulation. After childbirth, an intensive management period is required to simultaneously address postpartum Qi and blood recovery and the prevention of spondylitis reactivation.