POS0400-HPR NUMBER OF PREGNANCIES ASSOCIATED WITH COPING SKILLS AFTER A PERINATAL LOSS IN RHEUMATIC DISEASES
Authors: M. E. Corral-Trujillo, R. A. Cerda González, A. Carrazco-Chapa, A. L. Guajardo-Aldaco, J. A. Cardenas-de la Garza, L. Perez-Barbosa, C. M. Skinner-Taylor, D. A. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Women with autoimmune rheumatic diseases (ARDs) have greater risk of adverse obstetric outcomes during pregnancy, such as perinatal losses. Perinatal loss (PL) is defined as a defined as a loss from any gestational age or in the neonatal period [1]; it's considered a traumatic event that lead to the process of grieving, that involves emotional reactions such as sadness, disbelief and anger [2]. Grief can become pathological when the daily function and wellbeing of the person is compromised. Resilience refers to the individual's ability to recover their homeostasis and avoid developing a psychopathological outcome after acute or chronic stress exposure (8). Both psychological processes can be measure with different scales that can help health providers detect when a woman with a PL have a complicated grief (CG) [3] and intervene in a multidisciplinary approach. <h3>Objectives:</h3> Determine the frequency of CG and resilience capacity levels in women with ARDs and compare it with a control group. <h3>Methods:</h3> Descriptive, cross-sectional, comparative study at a University Hospital in México. Women with ARD and history of PL answer a virtual survey with the Perinatal Grief Scale (PGS) and the Wagnild and Young Resilience Scale (RS); sociodemographic and clinical data were obtained from the records. For the control group, women with history of PL from the Obstetrics and Gynecology outpatient clinic were invited to fill a survey with their sociodemographics, history of pregnancies and PL and the PGS and RS. The PGS is a Likert-type scale validated in Mexico of 27 items. The questions are distributed in four subscales: active grief (10 items), guilt (8 items), depression (6 items), and acceptance (3 items). Scores greater than 50 points suggests a CG comorbidity. The RS is a Spanish validated Likert-type scale of 25 items. The responses are summed in a total score from 25 to 175: higher scores suggest greater resilience. The Kolmogorov-Smirnov test was used to determine normality; to analyze the differences between groups, Mann–Whitney U, Chi-square tests and T-test were employed. A p &lt; 0.05 was considered statistically significant. <h3>Results:</h3> A total of 104 women were included: 52 women with ARD and 52 for the without ARD group. The mean age for the ARD group was 44 (±11.162) and 33.21 (±12.46) years for the control group. The main diagnosis for the ARD group was rheumatoid arthritis (RA) (n=21; 40%), followed by systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) with (N=10; 19.2%) of the cases. The sociodemographic characteristics are described in Table 1. We found 40 cases of complicated grief, 24 (60%) belonged to the control group and 16 (40%) to the ARD group. We found no significant difference between both groups. In the ARDs group, a negative correlation between the RS and the PGS scores was found, indicating that a lower resilience score correlates with a higher grief score (p=0.004, r=-0.390). Although in the control group no correlation was found (p=0.130, r=-0.213). The bivariate logistic regression analysis reported that the number of pregnancies (odds ratio [OR]= 0.606; P=0.002, 95% CI= 0.440 - 0.835) was independently associated with complicated grief. Meaning that there is a 1.65-fold reduction for complicated grief for each pregnancy. <h3>Conclusion:</h3> The resilience capacity between groups has no significant differences, which suggests that both groups are capable of coping with the emotional stress of suffering a PL. Also, having more pregnancies reduces the odds to develop CG. <h3>REFERENCES:</h3> [1] Côté-Arsenault D and Denney-Loelsch E (2016) "Have no regrets": Parents' experiences and developmental task in pregnancy with lethal fetal diagnosis. Social Sciences and Medicine 154, 100–109. [2] Bonanno GA and Kaltman S (2001) The varieties of grief experience. Clinical Psychology Review 21, 705–734. [3] Mota González C, Calleja Bello N, Aldana Calva E, Gómez López ME, Sánchez Pichardo MA. Escala de duelo perinatal: validación en mujeres mexicanas con pérdida gestacional. Revista latinoamericana de psicología. 2011 Sep;43(3):419-28. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>