26 June 2019

Arthritis diagnosis affects desire for children

Clinical Rheumatology Women

Receiving a diagnosis of arthritis directly influences the number of children that women want to have, a US study suggests.

A survey of around 270 women with arthritis, by CreakyJoints and ArthritisPower, found 60% wanted fewer children because of their diagnosis. Most of these women surveyed (79%) had RA.

Women in the survey said they would limit their family size because they were concerned about their ability to care for their children, feared their medication might harm a fetus or infant, were worried that their arthritis would be inherited by their kids, and were worried about premature death and not being able to raise their child.

“Despite significant improvements in the identification and treatment of inflammatory arthritis, this study suggests that the diagnosis all by itself makes women rethink how they want to build their families,” Dr Megan Clowse, a rheumatologist at Duke School of Medicine and an author of the study, said.

 “As physicians, we need to do a better job addressing patients’ concerns about perceived childbearing risks related to disease onset and treatment.

“Most existing studies show that women with inflammatory arthritis can have healthy pregnancies and children, particularly if their disease is well controlled at the time of conception.”

A minority of women surveyed (27%) had pregnancies after being diagnosed with arthritis. While around 40% of the women surveyed reported infertility.

“We’d also benefit from studying more closely why women with inflammatory arthritis seem to experience increased risk for infertility,” Dr Clowse said.

Around half of women reported arthritis flares over the course of their menstrual cycle, with 96% having worse disease activity around the time of menstruation.

Oral contraceptive pills were used by half of the women surveyed, and 82% reported that the pill didn’t seem to affect disease activity and nearly 10% said the pill improved symptoms.

“We surveyed women about menstruation and arthritic disease flares because our research registry community leaders, the ArthritisPower Patient Governors, raised colloquial concerns they had heard – via blogs or other unverified sources – that oral contraceptive pills could worsen inflammatory arthritis,” Dr Benjamin Nowell (PhD), the director of patient-centered research at CreakyJoints and study co-author, said.

“Yet data from several clinical studies, and now this one, instead suggest that these pills likely have no ill effect on inflammatory arthritis disease activity, and may even improve it for some.”

ACR Open Rheumatology