Impact of Childbearing Decisions on Family Size of Korean Women with Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) predominantly affects women in their reproductive years and has a significant impact on childbearing. We investigated the influence of personal decision on family size among Korean women with SLE and factors that affect the decisions. A case-control study comparing childbearing history and decisions of 112 SLE patients and 135 controls was performed. Women with SLE participating in the Network for Lupus Clinical Research in South Korea and matching controls between ages of 18-45, who are/were married or living with a partner were included. Data regarding socio-demographics, reproductive history, and childbearing decisions were collected through a survey using a standardized questionnaire and medical record review. More women with SLE reported at least one pregnancy (85.7% vs. 71.9%, P = 0.009) or at least one live birth (85.7% vs. 71.9%, P = 0.003) compared with controls. Mean number of pregnancies was significantly higher (2.4 ± 1.6 vs. 1.4 ± 1.3, P < 0.001), and mean number of live births was significantly lower in women with SLE (1.2 ± 0.8 vs. 1.6 ± 0.8, P < 0.001). Significantly more women with SLE made the decision not to have children compared with controls (54.5% vs. 40.7%, P = 0.031), and health-related concerns were the major cause of the decision. Other socio-demographic factors did not influence the decision to limit childbearing in SLE women. The disease-related concerns had significant impact on family size and childbearing decisions among Korean women with SLE.

Desire to have children and preferences regarding to pre-pregnancy counselling in women with SLE

“…Only a Saudi Arabian study reported 15% of 400 women without SLE attending primary healthcare centres, thought fertility in men and women with SLE was affected [ 27 ]. The frequency of childlessness attributed to SLE in our population was consistent with a recently published Korean study demonstrating 31% of women with SLE decided not to have children due to health-related reasons [ 2 ]. This case–control study, however, reports the avoidance of pregnancy (55% in women with SLE compared with 41% in controls) was higher compared with our population.…”

Incidence and prevalence of systemic lupus erythematosus among Korean women in childbearing years: A nationwide population-based study

“…Maternal complications such as lupus are, hypertension, nephritis, pre-eclampsia, and eclampsia and fetal complications such as fetal loss, stillbirths, preterm birth, and intrauterine growth retardation were more frequent during pregnancy in women with SLE compared with healthy women [13][14][15]. The disease also had a signi cant psychosocial impact on family life in that many SLE women make choices to limit family size due to concerns about the health of a child and their care [16][17][18]. Thus, women of childbearing age with SLE are among the most vulnerable population needing special attention, since a high disease burden is imposed upon this particular population group.…”

Risk of adverse pregnancy outcomes in Japanese systemic lupus erythematosus patients with prior severe organ manifestations: A single-center retrospective analysis

“…One major reason underlying this is health-related concerns. 1,50 Although the incidence of APOs was higher in our cohort than in the general population, the risk of APOs did not differ based on the presence of prior severe organ manifestation.…”