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Research ArticleVasculitis

Exploring Reproductive Experiences With Women Enrolled in the International Vasculitis Pregnancy Registry

Catherine A. Sims, Brian Perry, Christine Yeung, Heather Tam, Joyce Kullman, Renée L. Borchin, Cristina Burroughs, Peter A. Merkel and Megan E.B. Clowse
The Journal of Rheumatology October 2024, 51 (10) 997-1002; DOI: https://doi.org/10.3899/jrheum.2023-1055
Catherine A. Sims
1C.A. Sims, MD, Duke University, Division of Rheumatology & Immunology, Durham Veterans Affairs Healthcare System, Durham, North Carolina;
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  • For correspondence: cas206@duke.edu
Brian Perry
2B. Perry, MPH, Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina;
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Christine Yeung
3C. Yeung, BS, Vasculitis Patient-Powered Research Network, University of Pennsylvania, Division of Rheumatology, Philadelphia, Pennsylvania;
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Heather Tam
4H. Tam, Patient Advocate, Vasculitis Patient-Powered Research Network, Stanford, California;
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Joyce Kullman
5J. Kullman, Vasculitis Foundation, Kansas City, Missouri;
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Renée L. Borchin
6R.L. Borchin, BSW, C. Burroughs, BS, Health Informatics Institute, University of South Florida, Tampa, Florida;
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Cristina Burroughs
6R.L. Borchin, BSW, C. Burroughs, BS, Health Informatics Institute, University of South Florida, Tampa, Florida;
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Peter A. Merkel
7P.A. Merkel, MD, MPH, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania;
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Megan E.B. Clowse
8M.E.B. Clowse, MD, MPH, Division of Rheumatology & Immunology, Duke University, Durham, North Carolina, USA.
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Abstract

Objective This study explored the reproductive journeys of women with vasculitis, including their conversations with healthcare providers, disease activity, medication changes, and delivery experiences.

Methods Interviews were conducted with women registered in the Vasculitis Pregnancy Registry (VPREG), an online patient-reported registry of pregnant women with vasculitis. A team of physicians, patients, and qualitative researchers developed a qualitative interview guide. Participant responses were evaluated using thematic analysis.

Results Eighteen patients with vasculitis who had experienced pregnancy were interviewed (10 antineutrophil cytoplasmic antibody–associated vasculitis, 4 Takayasu arteritis, 2 Behçet disease, 1 IgA vasculitis, 1 relapsing polychondritis). Thematic analysis revealed common experiences in the decision-making process during pregnancy planning, including accessing information from multiple sources, communicating with medical professionals, and changing treatment for vasculitis. Women sought information about vasculitis and pregnancy from various sources, including social media; however, opinions from their physicians and family members were most influential. Patients were more likely than providers to initiate conversations regarding family planning. Balancing differing opinions from subspecialists was challenging as many patients recalled acting as a liaison between multiple physicians during pregnancy. The need for self-advocacy was a common experience among patients. Most women had pregnancies that resulted in live births with delivery at term.

Conclusion When making decisions about pregnancy, women of reproductive age with vasculitis used multiple resources. Patients consistently valued their medical provider’s opinion over alternative sources of information. To ensure comprehensive medical care, half of women relied on self-advocacy to coordinate communication among subspecialists. Most women had pregnancies that resulted in live births with delivery at term.

Key Indexing Terms:
  • pregnancy
  • qualitative research
  • reproductive healthcare
  • vasculitis
  • women’s health
  • Accepted for publication April 15, 2024.
  • Copyright © 2024 by the Journal of Rheumatology
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The Journal of Rheumatology
Vol. 51, Issue 10
1 Oct 2024
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Exploring Reproductive Experiences With Women Enrolled in the International Vasculitis Pregnancy Registry
Catherine A. Sims, Brian Perry, Christine Yeung, Heather Tam, Joyce Kullman, Renée L. Borchin, Cristina Burroughs, Peter A. Merkel, Megan E.B. Clowse
The Journal of Rheumatology Oct 2024, 51 (10) 997-1002; DOI: 10.3899/jrheum.2023-1055

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Exploring Reproductive Experiences With Women Enrolled in the International Vasculitis Pregnancy Registry
Catherine A. Sims, Brian Perry, Christine Yeung, Heather Tam, Joyce Kullman, Renée L. Borchin, Cristina Burroughs, Peter A. Merkel, Megan E.B. Clowse
The Journal of Rheumatology Oct 2024, 51 (10) 997-1002; DOI: 10.3899/jrheum.2023-1055
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Keywords

PREGNANCY
QUALITATIVE RESEARCH
reproductive healthcare
VASCULITIS
women’s health

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