To propose a framework for integrating sexual and reproductive health care into rheumatology practice for patients with systemic autoimmune and rheumatic diseases (SARDs).
Approach:
Key Findings:
Patients with SARDs face increased risks of adverse pregnancy outcomes, including preeclampsia and fetal death.
45% of nonpregnant patients with rheumatoid arthritis and 30% with systemic lupus erythematosus were prescribed teratogenic medications.
Only one-third of reproductive-age patients in rheumatology care had seen a gynecologist in the past two years.
Core competencies for rheumatologists include assessing pregnancy preferences, optimizing disease control, and counseling on medication safety.
Interpretation:
Adverse reproductive outcomes in patients with SARDs can be mitigated through proactive and coordinated care, emphasizing the need for improved integration of sexual and reproductive health services.
Limitations:
The framework primarily focuses on female patients, with limited attention to male patients, adolescents, and LGBTQIA populations.
The recommendations are not definitive standards but rather guidance for future research and clinical integration.
Conclusion:
Proactive, coordinated care in rheumatology can improve reproductive outcomes for patients with SARDs.
