AB1294\u2005IMPACT OF INFERTILITY, PREGNANCY LOSS AND CHILDBEARING DECISION ON FAMILY SIZE IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND RHEUMATOID ARTHRITIS

Abstract

Background: Systemic lupus erythematosus (SLE) and Rheumatoid Arthritis (RA) often affects women in their reproductive years. These women are faced with a life-long illness that may have considerable impact not only on their physical health, but also on their reproductive potential. Fertility of these women may also be affected by the disease, treatment and/or organ damage. Objectives: To determine the role of infertility, pregnancy loss and childbearing decision and patients concerns on family size in women with SLE and RA Methods: A cross sectional study using a self-administered reproductive history questionnaire completed by woman with SLE/RA attending Rheumatology clinic follow up in Hospital Putrajaya, Hospital Tengku Ampuan Rahimah, and Hospital Raja Permaisuri Bainun, Malaysia from 1 January 2017 to 30 June 2017. Within each disease cohort, women were identified into 3 groups, those with fewer children than planned (group A), those with same number of planned children (group B) and those with completed family or not interested in having any children (group C). Data on number of children, pregnancies, misscariges and self reported infertility were recorded.For group A, data on patient concerns and the factors that could impact family building were also obtained. Results: Total of 110 women with SLE and 91 women with RA were surveyed. The mean age of women with SLE and RA were 37.6 years (+/- SD 7.4) and 45.37 years (+/- SD 11.7) respectively. Majority of women (48.8%) with SLE and RA were in group A with 59% (n=65) of women with SLE and 33% (n=33) of women with RA had fewer children than originally planned. The average numbers of pregnancies were similar in both cohorts, but women with SLE had 1 less child and were more likely to report infertility and had higher rate of miscarriages (Table 1). SLE group A had a similar number of pregnancies, but 1 less child compared to SLE group B and C (Table 2). Similarly, among women with RA, group A had 1 less child with similar number pregnancies and miscarriage rate (Table 2). In both groups of women, concerns about inability to care for a child, damage from medications, and genetic transmission of their disease were associated with a lower pregnancy rate.Table 1 Number of pregnancies, live births, miscarriages and rate of infertility among women with SLE and RA* SLE RA P No. of pregnancies 2.28 ±1.626 2.60 ±1.949 0.128 No. of children 1.85 ±1.235 2.19 ±1.731 0.019 No. of miscarriages 0.46 ±0.809 0.36 ±0.659 0.040 No reporting infertility (%) 5 (4.5) 2 (2.2) 0.366 *values are the mean +/- SD unless otherwise indicatedTable 2 Pregnancy outcomes for women with SLE (n=110) and RA (n=91) * Fewer children than desired(group A) Expected number of children(group B) completed family (group C) SLE RA SLE RA SLE RA No. of woman, n (%) 65 (59.1) 33 (36.3) 20 (18.2) 31 (34.1) 25 (22.7) 27 (29.7) No. of pregnancies 2.11 ± 1.592 2.03 ± 1.723 2.3 ± 0.865 2.81 ± 2.12 2.72 ± 2.092 3.07 ±1.9 No. of children 1.57 ± 1.212 1.55 ± 1.416 2.1 ± 0.553 2.39 ± 4.856 2.36 ± 1.497 2.74 ± 1.745 No. of miscarriages 0.51 ± 0.831 0.36 ± 0.603 0.25 ± 0.716 0.32 ± 0.653 0.52 ± 0.823 0.41 ± 0.747 *values are the mean +/- SD unless otherwise indicated Conclusion: In this population, more than half of women with RA or SLE had fewer children than desired. Other than patient choice, infertility and miscarriage also play an important role on family size. References [1] Clowse, et al. Effects of Infertility, Pregnancy Loss, and Patient Concerns on Family Size of Women With Rheumatoid Arthritis and Systemic Lupus Erythematosus. Arthritis Care & Research.2012; 64 (5):668–674 [2] Vinet at al. Systemic Lupus Erythematosus in Women: Impact on Family Size. Arthritis & Rheumatism (Arthritis Care & Research).2008; 59 (11);1656–1660 Disclosure of Interests: None declared