Session Information
Date: Tuesday, October 23, 2018
Session Title: Reproductive Issues in Rheumatic Disorders Poster
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease, which predominantly affects women and reaches peak incidence during reproductive years. Periods of high disease activity are associated with maternal and fetal morbidity and mortality. Many medications, disease modifying anti-rheumatic drugs (DMARDS), used to treat SLE also have deleterious pregnancy effects. The literature provides clear guidelines for the best approaches to these practices for women with SLE; however, little is known about current practices. Our aim was to determine contraception practices within The Ohio State University (OSU) Lupus/Vasculitis/Glomerulonephritis (LVG) Registry.
Methods: The OSU LVG Registry prospectively collects clinical data of patient reported surveys including information on reproductive health. Per the Registry and chart review, patient reported sexual activity was assessed. An IRB approved retrospective chart review was conducted on female participants within the LVG cohort who received care for SLE between 2013 and 2018. Date collected included: patient demographics, sexual activity, contraceptive method (oral, surgical, devices, condom, or abstinence), and DMARD use.
Results: Within the registry, we had 259 female patients with SLE. Approximately half of the SLE cohort was on medications considered to be potentially teratogenic or non-compatible with pregnancy. Table 1 shows our SLE cohort demographics. 94% of the cohort self-reported as sexually active, with only about 25% reporting the use of prescription contraceptives (excluding post-menopausal women). An estimated 14% of sexually active patients reported using only condoms or abstinence while almost 27% use no method of contraception.
Conclusion: Within the LVG Cohort, SLE patients are on high risk medications with the potential for high risk pregnancy complications. This further demonstrates the need for assessing pregnancy intention, providing family planning counseling, and birth control methods in rheumatology practice. Further research is need
|
Table 1: SLE Cohort Demographics per Intake LVG Registry Questionnaire |
|
|
Characteristics |
(%) |
|
Age (years) |
|
|
Average age of patients |
42.6 |
|
Average age at diagnosis |
28.6 |
|
Sexually active |
|
|
Yes – using birth control |
31% |
|
No — not using birth control |
41% |
|
Not sexually active |
6% |
|
Menopausal |
22% |
|
Not answered (N = 114) |
44% |
|
Race |
|
|
Caucasian |
57% |
|
African American |
36% |
|
Asian |
3% |
|
Other |
1% |
|
Ethnicity |
|
|
Hispanic / Latino |
3% |
|
Non-Hispanic |
97% |
|
Education |
|
|
High school diploma or GED |
15.79% |
|
Associate’s degree or equivalent |
10.39% |
|
Bachelor’s degree or equivalent |
15.45% |
|
Some post-secondary education |
37.39% |
|
Master’s degree or higher |
10.80% |
|
Question Not Answered |
40% |
|
Contraception method |
|
|
Abstinence |
0.4 % |
|
Menopause |
21% |
|
None |
26.5% |
|
Sterilization |
1.6 % |
|
Ligation |
4.3% |
|
Hysterectomy |
14% |
|
Vasectomy |
1.9% |
|
IUD |
10.5% |
|
Implant |
4.7% |
|
Injection |
2.7% |
|
Pill-combo |
2.3% |
|
Pill-mini |
3.9% |
|
Patch |
0% |
|
Ring |
0.8% |
|
Condoms |
13.2% |
|
Diaphragm |
0% |
ed for the implementation of a sustainable patient and healthcare team education model in this high-risk population.
To cite this abstract in AMA style:
Mruk V, Weaver A, Zofia A, Sullivan E, Morris K, Ardoin SP, Berlan E, Meara A. A Description of Contraception Practices in the Ohio State University Lupus Cohort [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/a-description-of-contraception-practices-in-the-ohio-state-university-lupus-cohort/. Accessed April 8, 2020.« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-description-of-contraception-practices-in-the-ohio-state-university-lupus-cohort/