Utilization Rates of Contraceptive Methods in Patients with Rheumatic Disorders

Overview

This study evaluated contraceptive use among women aged 18-45 with systemic autoimmune and rheumatic diseases, highlighting the importance of effective contraception to prevent unplanned pregnancies and associated risks. Data were collected via a standardized questionnaire from patients with lupus, systemic sclerosis, Sjögren’s disease, rheumatoid arthritis, and related conditions.

Background

Systemic autoimmune and rheumatic diseases predominantly affect women of reproductive age and pose significant risks during pregnancy, including disease flares and adverse fetal outcomes. Certain medications used to control disease activity are teratogenic and must be discontinued before conception. Effective contraception is critical to prevent unplanned pregnancies and minimize maternal and fetal complications. Previous studies have focused mainly on lupus and lacked differentiation by contraceptive method effectiveness. This study aims to fill that gap by assessing contraception prevalence and its association with teratogenic treatments and pregnancy contraindications across multiple rheumatic diseases.

Data Highlights

The study included female patients aged 18-45 with diagnoses including systemic lupus erythematosus, Sjögren’s disease, systemic sclerosis, Sharp’s syndrome, rheumatoid arthritis, and spondyloarthritis. Data collection occurred from July 2023 to July 2024 using a self-report questionnaire assessing contraceptive use, reproductive history, and disease impact on maternity plans. Patients were recruited via in-person visits and mail distribution from national registries and reference centers. Data were pseudonymized and collected using REDCap and MySQL databases.

Key Findings

• Women with systemic autoimmune and rheumatic diseases have increased pregnancy risks including disease flares and adverse fetal outcomes.
• Effective contraception is essential to prevent unplanned pregnancies due to teratogenic medications and disease-related pregnancy contraindications.
• The study assessed contraceptive use across a broad spectrum of rheumatic diseases beyond lupus, including systemic sclerosis and rheumatoid arthritis.
• Data collection utilized a validated self-report questionnaire combined with medical record review for comprehensive reproductive and disease-related information.
• Recruitment strategies included both in-person and mail distribution to capture diverse patient populations from tertiary care and national registries.

Clinical Implications

Clinicians should emphasize the importance of effective contraception in women with rheumatic diseases, particularly those on teratogenic therapies or with contraindications to pregnancy. Comprehensive reproductive counseling and individualized contraceptive planning are vital to reduce unplanned pregnancies and associated maternal-fetal risks. Multidisciplinary collaboration between rheumatologists and gynecologists can optimize patient outcomes.

Conclusion

This descriptive analysis underscores the critical need for effective contraception in women with systemic autoimmune and rheumatic diseases to mitigate pregnancy-related risks. Tailored contraceptive strategies should be integrated into routine care for this population.

References

1. MARIGYN Project 2023-2024 -- Utilization Rates of Contraceptive Methods in Patients with Rheumatic Disorders