Building a Framework for Sexual and Reproductive Health Care in the Rheumatology Context: Content and Approaches

Area of Science:

• Reproductive Health
• Rheumatology
• Immunology

Background:

• Individuals with systemic autoimmune and rheumatic diseases (SARDs) have increased risks for adverse pregnancy and perinatal outcomes.
• Pregnancy-induced immune system changes can worsen outcomes for those with baseline immunologic dysfunction, especially with active inflammatory disease.

Purpose of the Study:

• To challenge the sole focus on immunologic and disease factors in adverse pregnancy outcomes for SARDs patients.
• To highlight the importance of high-quality sexual and reproductive healthcare (SRH) within rheumatology settings.
• To identify upstream factors that can enhance reproductive health for women with rheumatic diseases.

Main Methods:

• Commentary and literature review.
• Analysis of existing healthcare models.
• Exploration of emerging SRH approaches in rheumatology.

Main Results:

• A disease-centric focus may overlook crucial factors influencing reproductive health in SARDs.
• Integrating SRH care into rheumatology can improve person-centeredness, holistic care, and SRH equity.
• Emerging SRH strategies offer a framework for enhanced care.

Conclusions:

• Adverse pregnancy outcomes in SARDs are not solely driven by disease activity.
• High-quality SRH integrated into rheumatology care is vital for improving reproductive health.
• A holistic, person-centered approach to SRH in rheumatology is essential for equitable care.