Women's knowledge concerning the impact of chronic systemic diseases and related treatments on pregnancy

Many women of childbearing age are being treated for chronic conditions that require long-term medication. We assessed the knowledge of women being treated in internal medicine and clinical immunology, regarding the impact of their disease and specific treatments on a potential pregnancy.

Between September 1st, 2019, and November 1st, 2020, in four hospitals in the Poitou-Charentes region, a questionnaire was given to every woman aged 18 to 44 who came in for an internal medicine and clinical immunology consultation for the follow-up of a chronic systemic disease. Women who were already pregnant or breastfeeding were excluded.

One hundred and ten women were included. Lupus was the most common condition (29%). Knowledge of follow-up was adequate for 38%, 58%, and 86% of women with vasculitis, connective tissue disease or sickle cell disease, respectively. Regarding treatments, responses were correct for 71% of contraindicated treatments and 41% of authorized treatments. Knowledge was no better among women who wanted to become pregnant (correct answers for treatments: 34%) or among women who were not using contraception and did not want to become pregnant (correct answers for treatments: 50%). Only half of the women reported having received information on the subject from a healthcare professional.

Essential information on maternal and fetal safety is not properly understood by women of childbearing age, nor is it sufficiently communicated by healthcare professionals. It seems important to strengthen the questioning process and inform patients about the risks to mothers and fetuses.