AB0334 THE FIRST 1000 DAYS OF LIFE AND REPRODUCTIVE DISORDERS IN WOMAN WITH RHEUMATIC DISEASE (RDS)
Authors: M. Orlandi, S. Vannuccini, K. El Aoufy, M. R. Melis, G. Lepri, S. Bellando-Randone, S. Guiducci, M. Matucci-Cerinic, F. Petraglia
Journal: Annals of the Rheumatic Diseases (2021)

Background: Gynaecological problems are often ignored by rheumatologist and have a negative impact on quality of life of RDs patients. Objectives: The aim of this study was to describe gynaecological, reproductive and sexual problems in premenopausal woman with RDs. Methods: A monocentric, cross-sectional observational study was conducted in the Rheumatology Department of Careggi Hospital in Florence. Inclusion criteria: female gender, premenopausal age (and≥18 years old), diagnosis of rheumatic diseases. All patients have been investigated about gynaecological anamnesis and symptoms and subjected to a self-administered validated questionnaire. Results: From May 4 th to November 30th, 2020, 200 patients were enrolled (mean age 39.1± 8.7 years (M±SD)): 58% arthritis, 40% connective tissue disease and 1.5% systemic vasculitis. In the history, spontaneous, full-term birth in 91% and 93% of patients, respectively, was observed and pre-term birth was reported in 8.1%. 63% of patients were breastfed. In family history, menorrhagia, dysmenorrhea, or chronic pelvic pain were reported in 59%, 55 and 7% of patients, respectively. The first menstruation was at 12.3±2.0 years (M±DS) and mostly woman reported menstrual disorders during adolescence (56% experienced dysmenorrhea and 52% menorrhagia). Menstrual disorders and abnormal bleeding were frequently reported also in adulthood: 71% had dysmenorrhea, 38% heavy menstrual cycles and 9% metrorrhagia. Moreover, 26% of patients referred non- menstrual pelvic pain, 19% urinary pain and 18% pain during defecation. Vaginal symptoms were frequently reported: 36% of patients referred vaginal dryness, 29% burning, 19% recurrent vaginal infections and dyspareunia in 39% of patients. Uterine fibroma was present in 23% and endometriosis in 10% of patients. Fertility problems were reported by 10% of patients in a time frame of 7.5±6.4 years and 30% of patients experienced at least one miscarriage; otherwise, 56% of patients have had at least one full-term pregnancy. Conclusion: RDs patients show a high prevalence of various gynaecological problems affecting their quality of life. The management of female RDs patients is a challenge for the clinician and should include an accurate evaluation of the gynaecological aspects (menstruation, fertility, maternity, sexuality) as well as a multidisciplinary teamwork (rheumatologist and gynaecologists). References: [1]Critchley H., Babayev E., Bulun E., et al. Menstruation: Science and society | Elsevier Enhanced Reader. (s.d.). https://doi.org/10.1016/j . American Journal of Obstetrics &amp; Gynecology 2020.06.004 [2]Østensen M, Andreoli L, Brucato A,et al. State of the art: Reproduction and pregnancy in rheumatic diseases. Autoimmun Rev. 2015 May;14(5):376-86. doi: 10.1016/j.autrev.2014.12.011. Epub 2014 Dec 30. PMID: 25555818. [3]Marder W, Johnson TRB. Rheumatic diseases and maternal-fetal medicine. Best Pract Res Clin Obstet Gynaecol. 2020 Apr;64:1-2. doi: 10.1016/j.bpobgyn.2019.11.007. Epub 2019 Dec 17. PMID: 31983554. [4]Sammaritano LR, Bermas BL, Chakravarty EE,et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol. 2020 Apr;72(4):529-556. doi: 10.1002/art.41191. Epub 2020 Feb 23. PMID: 32090480. Disclosure of Interests: None declared