Keck School of Medicine, Department of Medicine Residency Program, University of Southern California, Los Angeles, California, USA.
Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, California, USA.
Lupus Sci Med. 2024 Feb 20;11(1):e001095. doi: 10.1136/lupus-2023-001095.
Management of reproductive health-related issues is crucial for patients with SLE, given this is a disease that primarily affects women of childbearing age. Little is known as to how the 2020 American College of Rheumatology (ACR) Reproductive Health in Rheumatic Disease Guideline is experienced by an underserved, primarily Hispanic population and their physicians as it relates to pregnancy planning and contraception conversations. Given this population experiences high rates of unplanned pregnancies and worse SLE outcomes compared with the non-Hispanic white population, it is crucial to understand how reproductive health is discussed in this setting.
A survey based on the 2020 ACR Reproductive Health Guideline was created and distributed in English and Spanish in the outpatient setting to 151 patients with SLE to determine patients' beliefs, experiences and limitations with reproductive health discussions. Associations between categorical variables were evaluated using Pearson's χ or Fisher's exact test, as appropriate, and differences in continuous variables were assessed using Wilcoxon rank-sum test.
English language survey respondents were significantly more likely to report having conversations regarding contraception, pregnancy planning and peripartum medication use than the Spanish survey respondents. Two-thirds of all respondents relied on the rheumatologist as a top source of reproductive health information.
Disparities exist regarding reproductive health conversations on multiple topics between English-speaking and Spanish-speaking populations with SLE. Further understanding is needed to clarify why reproductive health conversations occur at lower frequencies in Spanish-speaking SLE populations.
鉴于系统性红斑狼疮（SLE）主要影响育龄期女性，因此管理与生殖健康相关的问题对患者至关重要。目前尚不清楚服务不足的主要为西班牙裔人群及其医生如何体验 2020 年美国风湿病学会（ACR）风湿性疾病生殖健康指南，因为该指南涉及妊娠计划和避孕相关话题。鉴于该人群的意外怀孕率和 SLE 结局比非西班牙裔白人人群更差，了解生殖健康在这种情况下是如何讨论的至关重要。
根据 2020 年 ACR 生殖健康指南创建了一项调查，并以英语和西班牙语在门诊环境中向 151 名 SLE 患者发放，以确定患者在生殖健康讨论方面的信念、经验和局限性。使用 Pearson χ 或 Fisher 确切检验评估分类变量之间的关联，根据需要使用 Wilcoxon 秩和检验评估连续变量之间的差异。
与西班牙语调查受访者相比，英语语言调查受访者更有可能报告有关避孕、妊娠计划和围产期用药的讨论。所有受访者中有三分之二依赖风湿病医生作为生殖健康信息的主要来源。
在 SLE 患者中，英语和西班牙语患者在多个主题的生殖健康对话方面存在差异。需要进一步了解为什么西班牙语 SLE 人群中的生殖健康对话发生的频率较低。
