SAT0326 PLANS FOR MOTHERHOOD ARE CHANGED AFTER DIAGNOSING ANKYLOSIS SPONDYLITIS (AS). AS FEMALE PATIENTS’ ATTITUDE TO THE USE OF AS MEDICATIONS DURING PREGNANCY PLANNING AND CONCEPTION
Authors: Zuleykhan Gandaloeva, Olga Krichevskaya, Tatiana Dubinina
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Plans for motherhood are changed after diagnosing ankylosis spondylitis (AS). AS female patients' attitude to the use of AS medications during pregnancy planning and conception. <h3>Objectives</h3> To describe the impact of diagnosing AS on woman's plans to have children, and patients' attitude to continuing AS therapy while planning pregnancy or after definite conception. <h3>Methods</h3> 302 AS female patients participated in the survey conducted from May to November 2018. Patient's mean age was 32.4±6.0 years, average AS duration from onset of symptoms was 10.2±7.4 years. 224 (74.2%) respondents had higher education, 68 (22.5%) – vocational college education and 10 (3.3%) – secondary education. Totally 492 pregnancies were reported in 214 (70.9%) respondents, including 278 pregnancies before AS onset, while 214 occurred with underlying AS. <h3>Results</h3> 206 women (68,2%) have changed their attitude to potential pregnancy occurring during AS: – 12 (5.8%) were firmly set to terminate an unplanned pregnancy; – 21 (10.2%) were giving up on pregnancy because they already have children born before AS onset; – 9 (4.4%) were against getting pregnant, although they yet haven't had children; – 164 (79.6%) accepted potential pregnancy, although recognizing they would experience continuous emotional discomfort and fear for their own health and health of the unborn child. – 42 (13%) women were distinctly against getting pregnant in case they have AS. There was a weak inverse correlation between AS duration and changing patients' attitude to pregnancy (R=-0.14, p&lt;0.05). 150 (49.7%) respondents discussed pregnancy planning with a rheumatologist. Women with university degree were more likely to consult a rheumatologist before trying for a baby compared to subjects with vocational college and secondary education (55.5%, 35.3% and 40%, respectively; p=0.02). 53 (35.3%) patients failed to receive a comprehensive answer to their questions related to AS and pregnancy mutual influence, the probability of AS inheritance by a child, safety of AS therapy at conception and during pregnancy; moreover, in 4 cases AS was interpreted as contraindication to pregnancy. 107 (35.4%) respondents believe that AS medications should be discontinued during pregnancy planning and conception, 75 (24.8%) subjects accepted possible use of AS therapy during this period, while 120 (39.8%) didn't know the answer. 15.2% of respondents were ready to continue on NSAIDs, 20 (6.6%) – on glucocorticoids and sulfasalazine, and 21 (7%) – on biological drugs (GEBD). Of those who are ready to continue on AS medications at conception, 46 women (61.3%) consulted pregnancy planning with a rheumatologist. Respondents with higher education were slightly more likely to continue on AS therapy at conception (29%) compared to women with vocational college education (11.8%). Age, AS duration, or marital status had no influence on patients' attitude to AS therapy during pregnancy planning and conception. <h3>Conclusion</h3> The majority of surveyed female patients changed their attitude to pregnancy after establishing AS diagnosis, although only 13% of them were ready to avoid pregnancy due to AS. No more than 50% of respondents were consulted a rheumatologist before planning pregnancy, and up to one third of them were not receive all expected answers to their questions and recommendations. Only 1/4 of participants accept the idea of continuing AS therapy during pregnancy planning and conception. <h3>Disclosure of Interests</h3> None declared