When considering treatment options for rheumatoid arthritis during pregnancy, which category of drugs is strictly contraindicated?

The choice regarding the treatment of rheumatoid arthritis during pregnancy must be made with great consideration for both the mother's health and the developing fetus. Among the options provided, DMARDs such as Methotrexate are strictly contraindicated during pregnancy due to their teratogenic effects. Methotrexate has been associated with a range of serious fetal abnormalities, including neural tube defects and other organ malformations, if exposure occurs in the first trimester. Therefore, its use must be avoided in pregnant women or those planning to become pregnant, making this category of drugs specifically unsuitable.

On the other hand, biologics and glucocorticoids can be used with caution under specific circumstances during pregnancy, typically when the benefits outweigh the risks. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used but have restrictions, particularly in the third trimester due to potential risks like premature closure of the ductus arteriosus. Understanding the risk profiles of each class of medication is vital in managing rheumatoid arthritis effectively while safeguarding the health of both mother and child.