Background/Purpose: Biologics have been shown not to be a disruption in pregnancy, and the reproductive health care environment surrounding rheumatoid arthritis patients has improved significantly. In this study, we attempted to assess changes in attitudes toward pregnancy among female rheumatoid arthritis patients of childbearing age using a questionnaire.

Methods: A cross-sectional study using the NinJa database conducted at 49 sites in 2020, a database of RA patients in Japan collected from April 1, 2020 to March 31, 2021. We selected women under 50 years of age who answered a questionnaire on changes in the desired number of children due to the presence of rheumatoid arthritis. Of these, we excluded those who answered that they already had the desired number of children or that they did not want to have children. We compared the percentage of patients who reported that the onset of rheumatoid arthritis had reduced their desire for children in the three groups based on the time of onset of the disease (“before 2000,” “2001-2011,” and ” after 2012″). We also evaluated the stratification by age at onset (24 years and younger, 25 to 34 years, and 35 years and older), the reasons why respondents answered that they wanted fewer children.

Results: Of 15553 patients, 468 were selected, of which 188 were excluded, leaving 280 eligible cases. The number of patients who reported that the onset of rheumatoid arthritis reduced the desired number of children was 57% (20/35) for onset before 2000, 47% (63/133) for onset between 2001 and 2011, and 35% (39/112) for onset after 2012. Within each group, when further divided into three groups according to age at onset, especially in the 25-34 age group, the percentage of patients who reported a reduction in the desired number of children decreased with the time of onset.

We analyzed the reasons for the 122 patients who indicated that they wanted to have fewer children, and found that the most common reason was “I am worried about my ability to take care of my children” (40%: 49 patients). The next most common reason was “I am worried about the effects of the medication on my child” (25%: 30 patients).

Conclusion: In this study, the desired pregnancy outcome was particularly improved in the 25-34 age group, who are likely to be thinking about pregnancy and childbirth in the near future, possibly due to improvements in the treatment environment, such as an increase in the number of drugs available during pregnancy and the accumulation of information on pregnancy complicated by rheumatoid arthritis. On the other hand, the reasons behind the decrease in pregnancy desire may include limitations in physical function and financial burden, which will be an issue to be addressed in the future.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-number-of-rheumatoid-arthritis-patients-who-give-up-pregnancy-due-to-the-disease-is-decreasing/