Gout Flare-Ups During Pregnancy: What You Need to Know

When gout flare-ups during pregnancy, a painful joint inflammation caused by uric acid crystal buildup. Also known as acute gouty arthritis, it’s uncommon in pregnant women but can be severe when it happens. Most women see their gout symptoms improve during pregnancy because estrogen helps the kidneys flush out uric acid. But for some—especially those with a history of gout or kidney issues—flare-ups can still occur, often in the first or third trimester.

High uric acid, a waste product that forms when the body breaks down purines is the root cause. During pregnancy, blood volume increases, kidneys work harder, and hormone shifts can slow uric acid removal. If levels spike, crystals form in joints—usually the big toe, ankle, or knee—triggering swelling, redness, and sharp pain. Unlike non-pregnant patients, pregnant women can’t take most common gout drugs like colchicine or NSAIDs. Even ibuprofen is risky after 20 weeks. That’s why managing pregnancy and joint pain, discomfort in the joints caused by inflammation, hormonal changes, or pressure requires a different approach.

Safe options include rest, ice packs, staying hydrated, and avoiding high-purine foods like organ meats, shellfish, and alcohol. Low-fat dairy and cherries may help lower uric acid naturally. Your doctor might recommend acetaminophen for pain, but only at the lowest effective dose. Corticosteroid injections into the joint are sometimes used if pain is unbearable and other methods fail—they’re considered safe in pregnancy when properly administered. Monitoring kidney function and uric acid levels is key, especially if you’ve had gout before pregnancy.

Many women worry that gout means something’s wrong with their pregnancy. It doesn’t. It’s usually just a metabolic hiccup. But untreated, it can lead to complications like high blood pressure or preterm labor. That’s why tracking symptoms and talking to your OB-GYN early matters. You’re not alone—this is rare, but it happens. And when it does, the right steps can keep you and your baby safe.

Below, you’ll find real-world advice from people who’ve been there, plus trusted medical insights on what works, what to avoid, and how to navigate this tricky situation without reaching for risky meds.