Prevalence and Factors Associated with the Desire to Avoid Pregnancy in Never-Pregnant Patients with Systemic Lupus Erythematosus

<b>Objective:</b> To determine the prevalence and factors associated with the desire to avoid pregnancy in Thai patients with systemic lupus erythematosus (SLE). <b>Methods:</b> All female SLE patients (aged 18-50 years, menstruating, and never-pregnant) seen between November 2021 and July 2023 at Chiang Mai University Hospital were invited to participate in this cross-sectional questionnaire survey. The exclusion criteria were female patients with female partners and patients with overlapping syndromes. The participants were asked to rate their perception of SLE severity based on organ involvement and to indicate whether they wished to be pregnant. <b>Results:</b> Among the 201 participants (mean age 30.75 ± 7.77 years, median disease duration 9.31 years, single 73.37%, and tertiary level of education 85.50%), 127 (63.18%) desired to avoid pregnancy, with the reasons being personal decision in 72 (56.69%), fear of disease worsening in 60 (47.24%), past negative experience in 60 (47.24%), concern about fetal effects of disease or medications in 31 (24.41%), and physicians' recommendation in 10 (7.87%). Age, marriage or living with a partner, and having a tertiary level of education were independent factors associated with avoiding pregnancy, with adjusted odds ratios and 95% confidence intervals (AOR [95% CI]) of 1.07 (1.02-1.11), <i>p</i> = 0.005; 0.387 (0.18-0.77), <i>p</i> = 0.008 and 0.29 (0.10-0.81), <i>p</i> = 0.018, respectively. <b>Conclusions:</b> Over half of the Thai never-pregnant patients with SLE did not wish to become pregnant. Increasing age was an independent factor associated with this decision, while being married or living with a partner, as well as having a high level of education (tertiary education), were independent factors associated with less likelihood of avoiding pregnancy. Understanding why SLE patients of childbearing age do not wish to become pregnant could lead to greater flexibility in managing severe SLE disease.