Autoimmune Disorders Affect Birth Rates

New research suggests that more than half of women who suffer from autoimmune disorders, like rheumatoid arthritis (RA) and lupus, have fewer babies than planned. This study is the first of its kind to find an association between autoimmune disorders and different conditions, like infertility, miscarriages, and family planning choices in women.

Earlier studies have shown that women with RA have fewer children, when compared to their healthy counterparts, while women with lupus have more miscarriages. None of the studies have found the reason for the decrease in family size when women had RA or lupus. Megan Clowse, investigator from Duke University Medical Center, says that they wanted to learn more about this change in decisions when women were affected with RA and lupus, through the study.

In this study, 578 women with RA and 114 women with lupus were surveyed to find the association between these decisions and chronic diseases.

The results showed that:

• 55% of participants with RA and 64% of the participants with lupus had fewer children than expected or planned.
• More patients with rheumatoid arthritis reported infertility when they did not have planned number of children in the family.
• Women with lupus, who had fewer children than they had planned, had 3-fold higher chances of miscarriages. 

Of the total 578 RA patients, 42% of the participants who had fewer children than desired reported problems with conceiving. The investigators were surprised to see the result and suggest that women with RA who wish to have children need to be aware of the fact that their ability to conceive would be compromised when they have the disease. They should try to conceive early. Infertility might not be the explanation for the question as to why women with RA have fewer children than planned or expected.

The report shows that:

• 53% were concerned that the disease might negatively impact their child-rearing abilities.
• 37% were worried that the disease and the medications might affect pregnancy.
• 17% were concerned that the child also might develop the disease.

New York rheumatologist Cynthia Aranow suggests that women with autoimmune disorders should plan pregnancies carefully. Women with lupus can plan to conceive when the disease is inactive for a long time. This will considerably reduce the risk of miscarriage and premature birth. Women should deliberately avoid using certain medications, like methotrexate, which is used to give symptomatic relief from RA. Safe medications should be opted for during pregnancy.