Patient Perspectives on Reproductive Health in Systemic Lupus Erythematosus: Exploring Disease Manifestations, Quality of Life, and the Role of Social Support.

Abstract

Introduction/aim: Systemic Lupus Erythematosus (SLE) is an autoimmune condition that can cause a wide range of clinical symptoms, resulting in a substantial burden on its patients. This study examines how disease symptoms, quality of life, and social support affect SLE patients' reproductive health perspectives.

Methods: This cross-sectional study included all consecutive female SLE patients at a single-provider rheumatology clinic. Sixty-six patients provided data from September 2023 to March 2024. MSPSS, SLEDAI and WHOQOL-BREF scores were used to test patients perceived social support, disease activity and quality of life, respectively.

Results: The mean age of the study population was 39.62 ± 15.40 years. Constitutional symptoms were the most common disease manifestations (85.8%), followed by mucocutaneous and musculoskeletal symptoms (83.3% each). The mean SLEDAI score was 7.95 ± 9.29. Among previously married patients, 53.0% (n =35) had at least one child, and 81.0% of them experienced at least one pregnancy-related complication. Notably, 69.2% of patients were uncertain about the impact of SLE on fertility, and 91.0% had never received reproductive health counseling. Patients who were consulted by their Obstetrics and Gynecology (OBGYNs) doctors had significantly higher WHOQOL-BREF physical health (32.1 vs 10.3, P-value =0.036) and higher psychological health scores (63.2 vs 35.1, P-value =0.012).

Conclusion: SLE profoundly influences patients' physical, psychological, and social well-being, with a notable impact on reproductive health. Collaboration among OBGYNs and Rheumatologists to create a culturally sensitive method to address common misconceptions about SLE and infertility is needed.