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Background:The reproductive capacity of women with rheumatic diseases (RD) could be affected by factors such as sexual dysfunction, reduced gonadal function, foetal losses, drugs, and personal choices [1]. Studies have suggested that women with RD may underestimate their reproductive capacity [2], which may be reflected in unplanned pregnancies and/or adverse outcomes. One study found that women with rheumatoid arthritis (RA) have longer time to pregnancy compared to those without RA, suggesting that a reduction in fertility may be involved [3]. Another study found that patients with RA have more subfertility related to medication [4]. Aspects of sexual and reproductive health are not routinely addressed, so they are areas of opportunity to improve quality in care and research.Objectives:Identify demographic and clinical factors associated with pregnancy decision in women with RD.Methods:A population study was carried out including women with RD who had their first obstetric event from September 2017 to November 2020. According to the onset of sexual life and the year of conception of the first pregnancy, two groups were formed, who conceived before and after 5 years elapsed. Demographic and clinical data were obtained from medical records. Categorical variables were assessed using χ2 test and Fisher’s exact test where appropriate. Student’s t-test was used to assess continuous variables. A p value of 0.05 or less was considered significative.Results:Data were collected from 28 women, the main diagnosis was rheumatoid arthritis (21, 75%), followed by systemic lupus erythematosus (7, 25%), 14 of them (50%) were pregnant in the first 5 years after starting sex life. There were no differences in age of onset of sex life (p = 0.362), or other clinical characteristic, but women with pregnancies in the first lustrum had lower percentages of marriage union (35% vs 42%), paid-work (21% vs 28%), and use of highly effective contraception (21% vs 28%).Conclusion:Conclusions: No factors were identified for pregnancies in the first lustrum, but there is a tendency to occur in single women, non-employees, and users of non-highly effective contraceptives methods. Further studies with a larger population are necessary to find modifiable factors and improve outcomes.Table 1.Clinical characteristics.Obstetric event before 5 yearsObstetric event after 5 yearsp-valueTotal1414Current average age24.85 +/- 4.329.92 +/- 5.70.404Age at the first obstetric event, years20.92 +/- 2.928.00 +/- 5.90.05Age at the onset of rheumatic disease, years20.71 +/- 5.523.42 +/- 4.00.135Average age of onset of sex life, n (%)18.64 +/- 2.918.07 +/- 2.50.362Alcoholism consumption, n (%)3 (21.42)4 (28.57)0.663Tobacco use, n (%)3 (21.42)3 (21.42)Diabetes mellitus, n (%)0 (0)1 (7.14)0.309Hypertension, n (%)1 (7.14)0 (0)0.309Depression, n (%)3 (21.42)1 (7.14)0.280Anxiety, n (%)2 (14.28)1 (7.14)0.541Pre-pregnancy medicationMethotrexate, n (%)3 (21.42)5 (35.71)0.403Leflunomide, n (%)1 (7.14)2 (14.28)0.541Sulfasalazine, n (%)3 (21.42)2 (14.28)0.622Hydroxichloroquine, n (%)6 (42.85)4 (28.57)0.430Azathioprine, n (%)1 (7.14)0 (0)0.309Cyclophosphamide, n (%)2 (14.28)0 (0)0.142Glucocorticoids, n (%)5 (35.71)5 (35.71)NA: Not applicable.Image 1.Demographic characteristics.References:[1]Østensen, M., 2017. Sexual and reproductive health in rheumatic disease. Nature Reviews Rheumatology, 13(8), pp.485-493.[2]Birru Talabi, M., Clowse, M., Blalock, S., Switzer, G., Yu, L., Chodoff, A. and Borrero, S., 2019. Development of ReproKnow, a reproductive knowledge assessment for women with rheumatic diseases. BMC Rheumatology, 3(1).[3]Jawaheer, D., Zhu, J., Nohr, E. and Olsen, J., 2011. Time to pregnancy among women with rheumatoid arthritis. Arthritis & Rheumatism, 63(6), pp.1517-1521.[4]Brouwer, J., Fleurbaaij, R., Hazes, J., Dolhain, R. and Laven, J., 2017. Subfertility in Women With Rheumatoid Arthritis and the Outcome of Fertility Assessments. Arthritis Care & Research, 69(8), pp.1142-1149.Disclosure of Interests:None declared

Background:Pregnant women represent a high-risk population during the COVID-19 pandemic. The main cause of maternal deaths in Mexico during 2020 was COVID-19 with 191 (21.2%) deaths registered until December 2020. The age group most affected was 30 to 34 years. Women during their third trimester and during puerperium were the most affected. Information regarding pregnant and postpartum women with autoimmune rheumatic diseases remains scarce.Objectives:The aim of this study was to describe a COVID-19 case series from a clinic of pregnancy and rheumatic diseases.Methods:We conducted a descriptive, retrospective study in patients from the clinic of pregnancy and rheumatic diseases of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico. Pregnant patients with RD and documented COVID-19 between March and November 2020 were included. Demographic and clinical features were obtained. Results are shown in descriptive statistics.Results:From the 18 women with autoimmune rheumatic disease in follow-up during this period, 2 (11.1%) pregnant women, 2 (11.1%) postpartum women, and 1(5.5%) post-miscarriage woman developed COVID-19. The mean age was 28 ± 6.3 years, 3 (60%) had systemic lupus erythematosus, 1 (20%) had rheumatoid arthritis, and 1 (20%) had the antiphospholipid syndrome. Clinical features and treatments are shown in Graphic 1 and Table 1. The most frequent symptoms were fever (80%), cough (60%) and anosmia (60%). Four (80%) had mild symptoms, and 1 (20%) had severe symptoms requiring intensive care unit admission and mechanical ventilation. Three (60%) referred history of contact with a person who had COVID-19. All the patients were using hydroxychloroquine and prednisone. No patient in our study died.Conclusion:From our population, a total of 27.8% presented COVID-19. Most of our patients had a mild course of SARS-CoV-2 infection consistent with data from the general population. Additionally, none of our patients had risk factors such as hypertension, diabetes, chronic kidney disease or lung disease. Nonetheless, pregnant women remain a vulnerable population. Prevention measures must continue worldwide to avoid additional COVID-19 morbidity and mortality.References:[1]Gob.mx. 2021. INFORME SEMANAL DE NOTIFICACIÓN INMEDIATA DE MUERTE MATERNA. [online] Available at: <https://www.gob.mx/cms/uploads/attachment/file/601780/MM_2020_SE51.pdf> [Accessed 10 January 2021].[2]Arentz M, Yim E, Klaff L, et al. Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. JAMA. 2020;323(16):1612–1614. doi:10.1001/jama.2020.4326Graphic 1.Diagnosis, severity disease and clinical symptoms of pregnant rheumatic disease patients with COVID-19Table 1.Features, preventive measures, and treatments of pregnant rheumatic disease patients with COVID-19N=5Age, years, mean (SD)28 (6.36)Obesity, n (%)2 (40)Current occupation, n (%) Employee3 (60) Student1 (20) Housewife1 (20)  Positive PCR test, n (%)5 (100)Prevention measures, n (%) Social Distancing2 (40) Quarantine3 (60) Contact with a person who had COVID-193 (60)Treatments used before disease, n (%) Prednisone5 (100) Hydroxychloroquine5 (100) Sulfasalazine2 (40) Azathioprine1 (20) Methotrexate*1 (20)Rheumatic treatment during disease, n (%) Continued3 (60) Suspended2 (40)PCR: polymerase chain reaction, *Methotrexate was used during conception and suspended immediately after the pregnancy detection.Disclosure of Interests:None declared