Reproductive health counseling and contraceptive use in Mexican women with rheumatic diseases: a cross-sectional study

Rheumatol Int. 2021 Feb;41(2):409-414. doi: 10.1007/s00296-020-04679-1. Epub 2020 Aug 14.

Abstract

Background: There is an overall increased risk of adverse pregnancy outcomes and maternal morbidity in patients with most autoimmune rheumatic diseases (ARD); outcomes are generally improved when the pregnancy is planned and the disease is in control.

Objective: The objective of the present study was to describe the sexual and reproductive health characteristics and contraceptive use of Mexican women in childbearing age with ARD.

Methods: We conducted an observational, cross-sectional, and descriptive study. All non-pregnant childbearing age women with an ARD were invited to participate. A self-administered questionnaire of ten items that included questions about sexuality, use of contraceptive methods, pregnancy desire, and contraceptional counseling was applied.

Results: A total of 135 women were evaluated. The median age was 33 (25-39) years. Contraceptive use was referred by 49 (71%) of the patients that had sexual activity the last month, while 20 (28.9%) patients denied use. From the patients who had initiated sexual activity (N = 112), 41 (36.6%) did not use any contraceptive method, and 16 (14%) used a method classified as ineffective. The question about contraceptive counseling was answered by 112 patients. Eighty (70.4%) said they had received counseling from health-professional and 64 (57.1%) from their rheumatologist. A total of 57% of the women with teratogenic drugs did not employ a contraception method.

Conclusion: Contraceptive use and reproductive health counseling are suboptimal in Mexican women with ARD. A high proportion of women taking teratogenic drugs did not employ a highly effective contraceptive method. Strategies to improve reproductive and sexual health are necessary.

Keywords: Contraception behavior; Reproductive health; Rheumatic diseases; Rheumatoid arthritis; Systemic lupus erythematosus; Unintended pregnancy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Contraception / methods*
  • Contraception / statistics & numerical data
  • Contraception Behavior / statistics & numerical data
  • Counseling / standards
  • Counseling / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Mexico / epidemiology
  • Reproductive Health
  • Rheumatic Diseases / complications*
  • Rheumatology / methods
  • Rheumatology / standards
  • Surveys and Questionnaires