Rheumatologists' knowledge of contraception, teratogens, and pregnancy risks

Obstet Med. 2018 Dec;11(4):182-185. doi: 10.1177/1753495X18771266. Epub 2018 May 4.


Introduction: Rheumatologists are essential partners in planning and managing pregnancies in women with lupus. Whether they know the essentials of contraceptive and medical treatment in pregnancy, however, is unknown.

Method: Anonymous in-lecture surveys were completed by 270 rheumatologists to assess knowledge of contraceptive effectiveness, emergency contraception, medication teratogenicity, and lupus pregnancy risk assessment.

Results: Rheumatologists knew the high effectiveness of the intrauterine device, but over-estimated the effectiveness of injectable medroxyprogesterone and condoms. Almost all identified methotrexate as a teratogen, but only 69% identified cyclophosphamide and 37% mycophenolate. Most rheumatologists knew that lupus activity in pregnancy is the main predictor of pregnancy outcomes, but underestimated the risks of hypertension and race.

Conclusion: To improve lupus pregnancy planning and management, rheumatologists would benefit from improved knowledge about contraceptive effectiveness, teratogens, and the risks from non-lupus factors for pregnancy complications.

Keywords: Rheumatology; contraception; high-risk pregnancy; medical education.