Evaluation of pregnancy planning and contraceptive methods in patients with systemic lupus erythematosus

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Karakaş Ö., Tam D. Ç., Dağlı P. A., Ulusoy B. Ö., Armağan B., ERTEN Ş.

Gulhane Medical Journal, cilt.67, sa.2, ss.94-100, 2025 (Scopus, TRDizin)

Özet

Aims: Women’s educational background plays a crucial role in family planning, chronic disease management, and treatment adherence. Chronic diseases and the use of rheumatological medications can raise various concerns, influencing family planning decisions. This study aimed to evaluate pregnancy-related status, contraceptive methods, and factors contributing to pregnancy-related concerns in female patients with systemic lupus erythematosus (SLE) and to compare these findings based on educational levels. Methods: This cross-sectional study included women aged 18–49 diagnosed with SLE based on the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology classification criteria. Participants were eligible if they were planning a pregnancy, currently pregnant, or had a prior pregnancy history. Patients with overlapping autoimmune diseases or those unwilling to participate were excluded. The primary outcome was the assessment of pregnancy-related concerns and contraceptive methods. Data were collected through structured interviews and analyzed using statistical tests to compare groups based on educational levels. Results: A total of 71 female patients were included, with a median age of 42 years [interquartile range (IQR): 36–48], and the majority were married (75.3%). The median disease duration was 9 years (IQR: 5–14). Only 25.0% of the patients consulted their physician before planning a pregnancy, and 37.1% used contraception. The most commonly used contraception methods were condoms (17.8%), intrauterine devices (14.5%), and oral contraceptives (4.8%). The most common concern was the belief that medications could harm the baby (32.7%). No significant differences were observed in primary outcomes when comparing educational levels (p>0.05). Conclusions: This study highlights low rates of preconception counseling and contraceptive use among female SLE patients, as well as prevalent concerns regarding pregnancy-related risks.