Reproductive health knowledge and contraceptive use in never pregnant systemic lupus erythematosus patients: A cross-sectional survey

Abstract

Objective

To assess knowledge of reproductive health (pregnancy and contraception) in systemic lupus erythematosus (SLE) patients with no history of pregnancy.

Methods

This cross-sectional study included SLE patients (aged 18–50 years, menstruating, and never pregnant) who attended Chiang Mai University Hospital between November 2021 and July 2023. They completed a reproductive health knowledge assessment and provided information on their contraceptive use.

Results

Of 204 SLE patients (mean age 30.91 years, 73.76% single, 27.45% with active nephritis, 62.75% on immunosuppressive drugs), 83.82% and 57.53% had adequate knowledge of pregnancy and contraception in SLE patients, respectively. Among 101 patients with sexual experience, 91 (43.96%), currently active, provided their contraceptive practice. Male condoms and withdrawal methods were commonly used. None of the patients used intrauterine devices. Compared to the past, the current use of male condoms and withdrawal has significantly decreased (76.92% to 62.64%, p = .007, and 47.25% to 37.36%, p = .020, respectively), and effective contraceptive methods (oral contraceptive pills and medroxyprogesterone acetate injections) also have significantly declined (19.78% to 2.20%, p < .001, and 8.79% to 4.40%, p = .046, respectively). In contrast, the proportion of entirely no contraceptive used slightly but significantly increased (2.20% to 7.69%, p = .025). There was no difference in contraceptive methods used, frequency of sexual activity, and SLE disease activity between patients who did and did not live with their partners.

Conclusions

Knowledge of reproductive health, particularly contraceptive use in SLE patients, remains suboptimum. Formal reproductive health counseling should be carried out in all SLE patients for better contraception planning.