Background/Purpose: This study aims to find out knowledge, attitude, practices and beliefs of patients with autoimmune rheumatic diseases regarding family planning, contraception, drug use and various factors which can affect pregnancy.

Methods: It was a cross-sectional observational study conducted in a tertiary care center of North India. A validated questionnaire-based survey was filled by 255 married females in the reproductive age group attending rheumatology OPD over a period of one year. Postmenopausal women, widowed/divorced/separated couple and those not giving consent were excluded from the study. Simple descriptive analysis of data was performed using absolute numbers and percentages for categorical variables and mean ± standard deviation for continuous variables.

Results: Section 1: Contraceptive awareness and usageMost of the patients (245/255, 96%) were aware regarding family planning and contraception with most information sourced from mass media or the internet (136/255, 53.3%) followed by friends or relatives (87/255, 34%). Only 61/255 (24%) learned about contraception from physicians, suggesting a potential gap in physician-patient discussions on family planning. 198/255 (77.64%) patients reported that they were never told anything about the contraceptives during OPD visits. Barrier method (condoms) was most widely known (204/255, 80%) and most preferred (160/212, 75.47%). The most common reasons for not using contraception included lack of knowledge (32/96, 33.3%) and safety concerns (22/96, 22.91%).Section 2: Awareness regarding rheumatological drugs and their impact on fertility and breastfeedingOver half of patients (142/255, 55.68%) were unaware of the medications they were prescribed for their rheumatological condition and majority of them (220/255, 86.27%) were unaware of the availability of safe drugs for use during pregnancy. Nearly two third of the patients (165/255, 64.7%) believed that taking medications during pregnancy could adversely affect fetal growth. More than half of them (151/255, 59.21%) thought breastfeeding could lead to disease transmission. Section 3: Awareness of the impact of rheumatic diseases on pregnancy and vice versaMore than two third of the patients (176/255, 69.01%) were unaware of how disease activity could affect pregnancy. Similarly, 174/255 (68.23%) were unaware of how pregnancy could affect disease activity. A significant number (184/255, 72.15%) were unaware of the duration of disease remission needed before conceiving, and only 38/255 (14.9%) were aware of the recommended six months of remission.

Conclusion: Study highlights the need for improved physician-patient communication which could significantly enhance the reproductive health and outcomes for patients with rheumatological conditions

Table 1: Baseline Characteristics

Figure 1 A : Pie chart showing awareness regarding family planning and contraception in patients attending rheumatology OPD, 1B : Pie chart showing physician initiated discussions for patient education regarding contraceptive measures in OPD, 1C: Bar graph showing reasons stated by patients for not initiating discussions regarding family planning and contraception by themselves during OPD visits, 1D : Pie chart showing knowledge among patients regarding the availability of safe drugs for rheumatologic diseases during pregnancy, 1E: Pie chart showing patients’ belief regarding possibility of adverse impact on fetus on taking prescribed anti-rheumatic drugs, 1F: Pie chart depicting awareness among patients regarding the duration of remission of rheumatologic disease prior to planning pregnancy

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/awareness-regarding-contraceptive-measures-drug-usage-and-factors-affecting-pregnancy-among-patients-with-autoimmune-rheumatic-diseases/