Background Adequate prenatal counseling in women with autoimmune rheumatic diseases (ARDs) may help minimize maternal-fetal complications. However, the available information about the frequency and quality of prenatal counseling given to these patients is limited.
Objectives To estimate the prevalence of preconceptional counseling and associated factors in women with ARDs.
Methods A survey was conducted on socio-demographic data, gynecological-obstetric history, and domains related to preconception counseling in women with ARDs at the reproductive stage. It was defined as adequate preconception counseling if the patient knew that the pregnancy should be medically planned, that the complications are associated with severity/activity of the disease, that they should use an effective contraceptive method and that their medications may or may not be used during pregnancy. Descriptive statistics, Student's T test for quantitative variables with normal distribution, Mann-Whitney U test for non-normal and chi-square distribution were used for categorical or ordinal variables.
Results Of a total of 146 surveys, 131 were analyzed. Only 49 (37.4%) patients received adequate preconception counseling. Two thirds of the patients had systemic lupus erythematosus (Table). The time of evolution of the disease was a factor associated with receiving adequate counseling (5.6 vs 3.6 years, p=0.023). Illness, marital status, and level of education were not factors associated with adequate counseling. The adoption of a contraceptive method and the number of pregnancies were not different between the two groups. The history of use of embryotoxic/teratogenic drugs was associated with a higher frequency of adequate counseling (79.6% vs 41.5%, p=0.001). According to the patients, adequate counseling was given by the rheumatologist in 75.5% of the cases (p=0.001).
Conclusions Adequate preconceptional counseling in our patients with ARDs at the reproductive stage is deficient. A multidisciplinary strategy is required to improve the frequency and quality of preconception counseling in patients with ARDs.
Disclosure of Interest None declared