Background/Purpose: Autoimmune rheumatic diseases (ARDs) commonly affect women of childbearing age. Active maternal disease in the months prior to conception increases the risk of flares during pregnancy and adverse pregnancy outcomes. Therefore, maternal and fetal health can be optimized by planning conception when the disease is controlled so that a treatment regimen can be kept throughout the pregnancy.

This study aims to carry out the construction and validation of a Reproductive Health Questionnaire (RHQ) for patients with ARDs.

Methods: A validation and construction of a RHQ was carried out in women of reproductive age (18 to 50 years) with ARDs. The validation was realized in two phases. First phase: The National Demographic Dynamics Survey (2018) was used as the basis for obtaining the questions to form the draft questionnaire, as well as a previous non-validated questionnaire then a review of the literature and construction of the questionnaire was performed by a multidisciplinary team of experts, then the first version of the questionnaire was made. Second phase: During face and content validity, the multidisciplinary group met to assess the relevance of the written questions to create the second version of the questionnaire, following we carried out pilot tests to create versions 3, 4, and 5. Figure 1. A Cross-sectional study was conducted to complete the validation and estimate Cronbach’s alpha based on tetrachoric correlation coefficients, correlation matrix, and Cohen’s kappa coefficient test. The stability of the instrument was measured by comparing two measurements on the same study subject (re-test) with a time-lapse between them.

Results: A convenience sampling was carried out with a sample of 165 women, 65 women participated in the cross-cultural adaptation phase and 100 in the validation phase.

First phase: we developed an instrument of 38 questions; some drafting questions were modified because of the confusion or disconcerting they caused to some patients, furthermore more response options were added (Figure 1). In the second phase, version 5 of the RHQ was applied to 100 women with ARDs, the average age of the patients was 35 years. The most frequent disease was rheumatoid arthritis (54%). We founded a difference of 6 months between the onset of the symptoms of the disease and the diagnosis. The correlation matrices showed good to moderate correlations in dimensions 3, 5, 6, 7, 8, and 10 (0.53, 0.82, 0.84, 0.54, 0.35, and 0.45 respectively), we founded difficulties in two dimensions, therefore they were restructured. The test-retest analysis showed perfect correlations in 34 of the 41 items, moderate correlations in 6 items, and a negative correlation on one of the items due to a change in the reproductive status of one patient.

Conclusion: The RHQ is a useful and practice tool to assess reproductive health (fertility, reproductive preferences, contraception, preconception counseling, sexuality, and breastfeeding) in women with ARD, and could help with timely intervention on reproductive health issues, decreasing both fetal and maternal adverse outcomes.

Figure 1. Phases

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/construction-and-validation-of-a-reproductive-health-questionnaire-for-women-with-rheumatic-diseases/