Contraceptive use in women of childbearing ability with rheumatoid arthritis: A university hospital-based survey

Aim of the work

The study aimed to determine the pattern of contraceptive use in rheumatoid arthritis (RA) patients in Saudi Arabia.

Patients and methods

This study was conducted among women with RA and childbearing ability who were seen at rheumatology clinics in King Abdul-Aziz University Hospital (KAUH) through a survey on the medications received and contraceptive method used.

Results

Their mean age was 27.5 ± 4.6 years and had disease duration of 3.6 ± 0.9 years. Rheumatoid factor and anti-cyclic citrullinated peptide are positive. 29.2% of the patients were illiterate and only 8.2% attended high school. Of the 158 women, 36 (86.1%) were Saudis. Methotrexate was received alone (19.6%) or in various combinations in the rest of the patients (80.4%). 109 (69%), used combined oral pills, 38 (24%) used intra-uterine device (IUD) while 7 (11%) used non-medical methods of contraception such as using condoms, withdrawal and abstinence. Using combined oral pills were used significantly more among Saudis (72.1% vs 50%) as well as IUDs (27.2% vs 4.5%)(p < 0.0001), and those who attended middle school significantly used more combined oral pills (80.4%) while those with high school used more IUDs (38.5%) (p = 0.01).

Conclusion

The commonest contraceptive method was oral contraceptives in female RA patients. However, a considerable percentage used IUD. There is a need for effective contraceptive counseling as part of routine chronic disease care and that will improve childbearing women’s contraceptive knowledge and contraceptive choice. This could be the key to decrease unintended pregnancies among these women.