Prevalence of effective contraceptive use among patients with rheumatic diseases: a descriptive study

Systemic autoimmune and chronic inflammatory rheumatic diseases predominantly affect childbearing women. These women are at greater risk for pregnancy complications stemming from both the underlying disease and the treatments required to manage it. This cross-sectional study aimed to assess the prevalence of effective contraceptive use across a wide range of diseases including systemic lupus, systemic sclerosis, Sharp syndrome, Sjögren’s disease, rheumatoid arthritis, and spondyloarthritis. We conducted a questionnaire-based study targeting women aged 18–45 years with any of the aforementioned diseases. The data were collected from July 2023 to July 2024. A standardized self-report questionnaire, specifically developed for this study, was used to assess gynecological follow-up and reproductive health. Additional clinical data were extracted from patients’ electronic medical records. Descriptive statistics were used to analyze contraception use across different risk groups, including those on teratogenic treatments and those at increased maternal or fetal obstetric risk. 143 patients were included; among those not trying to conceive, 63% used effective contraception. This rate is lower than the 72% reported for the general population in France in 2016. Among previously pregnant patients, 33% experienced an unplanned pregnancy, highlighting the impact of contraceptive failure. There was no difference between patients on teratogenic treatments, those with increased maternal or fetal obstetric risk, and other patients. This study emphasizes the urgent need for improved education and gynecological management of young women with rheumatic diseases in France. Specific educational programs and enhanced gynecological follow-ups are necessary to address this critical gap. This study was registered with ClinicalTrials.gov (NCT05961267), first posted on the 24th of July, 2023, and in the European database (ID-RCB 2023-A01207-38).