POS0088 GAPS IN FAMILY PLANNING COUNSELLING FOR WOMEN WITH RHEUMATIC DISEASE IN KUWAIT
Authors: A. Albasri, M. Khudadah, G. Aldabie
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatic and musculoskeletal diseases (RMDs) often affect females of childbearing age. Given the potential adverse impact of disease and therapeutics on pregnancy outcomes, along with the possible effects of pregnancy on disease control, the significance of preconception counselling and family planning is clear in this group of patients. <h3>Objectives:</h3> This study aims at identifying gaps in counselling female patients with RMDs, of child-bearing age, regarding family-planning provided by rheumatologists in Kuwait. <h3>Methods:</h3> A cross sectional study has been conducted in the outpatient departments of 7 governmental hospitals in Kuwait using anonymized electronic survey. The survey consisted of 20 questions measuring patients' demographics, rates of pregnancy counselling, and patient perceptions regarding pregnancy and breastfeeding in relation to their rheumatic disease and medications was used. Non-pregnant females aged 21-49 with confirmed rheumatological diagnosis were included. Current pregnancy, history of primary or secondary infertility, and patients advised against getting pregnant by their doctors were excluded. Analysis of the results was completed for the enrolled patients from June 4<sup>th</sup> to November 13<sup>th</sup>, 2023. <h3>Results:</h3> In total, 94 patients responded to the survey. Age groups of 21-30, 31-40, and 41-49 years were 25%, 44% and 31%, respectively. 78% were Kuwaiti nationals and 74% had a college degree or higher. Of responders, 42% were diagnosed with systemic lupus erythematosus, 31% rheumatoid arthritis and 13% psoriatic arthritis. The mean disease duration was 7.5 years (SD 6.3). 54% reported having at least 1 to 3 live births while 20% had no offspring at the time of survey. Moreover, 40.5% of the responders had history of pregnancy loss and 37% were using a contraception method at the time of the survey. Up to 69% received counselling regarding the importance of adequate disease control for a period of 3-6 months prior to conception. However, 75% haven't been counseled regarding the need for contraception, regardless of their disease or treatment, including teratogenic medications. Moreover, 61.7% received counseling on the impact of their disease on pregnancy or the fetus and 57.5% were counselled regarding the need for pre-conceptional assessment. Finally, 51% were willing to have future pregnancies. If it was deemed safe, 70% and 65% would continue their treatment during pregnancy and breastfeeding, respectively. Concerns regarding adverse pregnancy and fetal outcomes were the main reasons for stopping treatment during future pregnancy and breast feeding. <h3>Conclusion:</h3> A large proportion of our female patients plan for pregnancy regardless of their condition and treatment. However, we found major gaps in pre-conception counselling and contraceptive advice given by rheumatologists, potentially increasing the risk of adverse pregnancy and fetal outcomes. Interventions are needed to address these gaps, and future research is warranted to examine barriers to counselling. <h3>REFERENCES:</h3> [1] Birru Talabi M, et al. Family Planning Counseling for Women With Rheumatic Diseases. Arthritis Care Res (Hoboken). 2018 Feb;70(2):169-174. [2] Chew C, et al. "r/ Thritis", pregnancy, and parenting: a qualitative descriptive study of reddit forums to explore information needs and concerns of women with rheumatoid arthritis. ACR Open Rheumatol 2019; 1:485–92. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>