SAT0326 PLANS FOR MOTHERHOOD ARE CHANGED AFTER DIAGNOSING ANKYLOSIS SPONDYLITIS (AS). AS FEMALE PATIENTS’ ATTITUDE TO THE USE OF AS MEDICATIONS DURING PREGNANCY PLANNING AND CONCEPTION

Abstract

Background Plans for motherhood are changed after diagnosing ankylosis spondylitis (AS). AS female patients’ attitude to the use of AS medications during pregnancy planning and conception. Objectives To describe the impact of diagnosing AS on woman’s plans to have children, and patients’ attitude to continuing AS therapy while planning pregnancy or after definite conception. Methods 302 AS female patients participated in the survey conducted from May to November 2018. Patient’s mean age was 32.4±6.0 years, average AS duration from onset of symptoms was 10.2±7.4 years. 224 (74.2%) respondents had higher education, 68 (22.5%) – vocational college education and 10 (3.3%) – secondary education. Totally 492 pregnancies were reported in 214 (70.9%) respondents, including 278 pregnancies before AS onset, while 214 occurred with underlying AS. Results 206 women (68,2%) have changed their attitude to potential pregnancy occurring during AS: – 12 (5.8%) were firmly set to terminate an unplanned pregnancy; – 21 (10.2%) were giving up on pregnancy because they already have children born before AS onset; – 9 (4.4%) were against getting pregnant, although they yet haven’t had children; – 164 (79.6%) accepted potential pregnancy, although recognizing they would experience continuous emotional discomfort and fear for their own health and health of the unborn child. – 42 (13%) women were distinctly against getting pregnant in case they have AS. There was a weak inverse correlation between AS duration and changing patients’ attitude to pregnancy (R=-0.14, p 150 (49.7%) respondents discussed pregnancy planning with a rheumatologist. Women with university degree were more likely to consult a rheumatologist before trying for a baby compared to subjects with vocational college and secondary education (55.5%, 35.3% and 40%, respectively; p=0.02). 53 (35.3%) patients failed to receive a comprehensive answer to their questions related to AS and pregnancy mutual influence, the probability of AS inheritance by a child, safety of AS therapy at conception and during pregnancy; moreover, in 4 cases AS was interpreted as contraindication to pregnancy. 107 (35.4%) respondents believe that AS medications should be discontinued during pregnancy planning and conception, 75 (24.8%) subjects accepted possible use of AS therapy during this period, while 120 (39.8%) didn’t know the answer. 15.2% of respondents were ready to continue on NSAIDs, 20 (6.6%) – on glucocorticoids and sulfasalazine, and 21 (7%) – on biological drugs (GEBD). Of those who are ready to continue on AS medications at conception, 46 women (61.3%) consulted pregnancy planning with a rheumatologist. Respondents with higher education were slightly more likely to continue on AS therapy at conception (29%) compared to women with vocational college education (11.8%). Age, AS duration, or marital status had no influence on patients’ attitude to AS therapy during pregnancy planning and conception. Conclusion The majority of surveyed female patients changed their attitude to pregnancy after establishing AS diagnosis, although only 13% of them were ready to avoid pregnancy due to AS. No more than 50% of respondents were consulted a rheumatologist before planning pregnancy, and up to one third of them were not receive all expected answers to their questions and recommendations. Only 1/4 of participants accept the idea of continuing AS therapy during pregnancy planning and conception. Disclosure of Interests None declared