AB1050 ANALYSIS OF FACTORS INFLUENCING THE NUMBER OF CHILDREN OF FEMALE SLE PATIENTS BY PATIENT’S QUESTIONNAIRE
Authors: A. Ogawa, H. Tsuji, Y. Nakakubo, T. Yoshida, T. Iwasaki, M. Shirakashi, H. Onizawa, R. Hiwa, K. Kitagori, S. Akizuki, R. Nakashima, A. Onishi, H. Yoshifuji, M. Tanaka, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) is more likely to occur in young women, and it has been reported that it affects the health of mothers and children during pregnancy and childbirth. SLE patients have fewer children than healthy subjects, and contributing factors are thought to include older age, thyroid dysfunction or antiphospholipid syndrome (APS) comorbidities, history of cyclophosphamide (CYC) use, non-steroidal anti-inflammatory drugs (NSAID) or high-dose glucocorticoid use, and elevated SLE Disease Activity Index (SLEDAI) scores 1). However, there are few reports on the effects of aging, social factors, and psychological factors on pregnancy by direct survey for patients. <h3>Objectives:</h3> We analyzed the influence of disease-related factors, social factors, and psychological factors on the number of children for SLE patients. <h3>Methods:</h3> We conducted a questionnaire about thoughts and desires regarding pregnancy and relationships with surrounding people and collected medical record information from SLE patients in Kyoto Lupus Cohort registry. Patients were classified into 2 groups by their age of onset: SLE onset before the age of 40 (early onset group) and SLE onset after 40 years old (late onset group). For comparison between two groups, Student t-test and Mann-Whitney U test were performed. A multiple regression analysis was performed to examine the effects of APS comorbidity, nephropathy, history of CYC use, intentional avoidance of pregnancy, and age at first birth at age 30 or older on the number of children. Data were analyzed with R (ver 4.0.2). P values less than 0.05 were considered significant. <h3>Results:</h3> Of the 277 SLE patients who responded to the questionnaire (response rate 87%), 262 were women, and 207 (79.0%) were in the early onset group and 53 patients (20.2%) were in the late onset group. There was a significant difference in the mean number of children between the early onset group (0.75) and the late onset group (1.48) (p &lt;0.01). There were no significant differences in APS comorbidities, nephropathy, history of CYC use, intentional avoidance of pregnancy, and mean age at first birth between the two groups. A significant correlation was observed between the age of onset with the number of children in the early onset group (ρ = 0.30, p &lt; 0.01, Figure 1(A)), while no significant correlation was observed between them in the late onset group (ρ = 0.06, p = 0.67). Intentional avoidance of pregnancy (β = -0.35, p = 0.036) and age at first birth older than 30 years (β = -0.67, p &lt; 0.01) showed significant associations with number of children by multivariate analysis in the early-onset group. In the questionnaire, many patients consulted their doctor or partner about pregnancy, but some were unable to consult with others and avoided pregnancy. In addition, it was found that many patients avoided pregnancy because of the possibility that the drugs they were taking might affect their children or because their SLE was highly active. (Table 1) Furthermore, there was a significant negative correlation between age at first birth and number of children (ρ = -0.48, p &lt; 0.01, Figure 1(B)). <h3>Conclusion:</h3> This analysis revealed disease-related, social factors, and psychological factors that influence pregnancy. Since the environment for pregnancy of SLE patients were underdeveloped, it was suggested that conception planning in SLE patients could be improved by the support through appropriate consultation and patient guidance, and appropriate treatments using medication not affecting pregnancy. <h3>REFERENCES:</h3> [1] Stamm B, Barbhaiya M, Siegel C, Lieber S, Lockshin M, Sammaritano L. Infertility in systemic lupus erythematosus: what rheumatologists need to know in a new age of assisted reproductive technology. Lupus Sci Med. 2022 Dec;9(1):e000840. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>