IMPACT OF CHILDCARE ON PATIENT-REPORTED OUTCOME IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A CROSS-SECTIONAL STUDY FROM THE LUPUS REGISTRY OF NATIONWIDE INSTITUTION (LUNA) COHORT

O067 / #277

Topic: AS21 - Pregnancy and Reproductive Health

ABSTRACT CONCURRENT SESSION 11: PREGNANCY IN SLE

24-05-2025 10:40 AM - 11:40 AM

Background/Purpose Systemic lupus erythematosus (SLE) often develops at a young age leading to concerns regarding pregnancy, childbirth, and childcare. Although recent advances in treatment have increased safety during childbirth, the situation of patients with SLE raising children alongside their treatment is unknown. The quality of life (QOL) in healthy individuals tends to decline from the postpartum to the parenting period. However, the burden of parenting may be greater in patients with SLE than in healthy individuals because of perinatal relapse and child-rearing difficulties due to fatigue and functional impairment. In this study, we examined the impact of childcare on the QOL of patients with SLE.

Methods This cross-sectional study used data from a multicenter SLE registry, the lupus registry of nationwide institution (LUNA). We excluded female patients with a confirmed parenting status, those within 8 weeks postpartum, those with cancer, and those whose child’s age could not be confirmed. First, to evaluate the impact of childcare on patients’ QOL during treatment, the exposure was parenting, divided into 2 categories (including infants aged 0–5 years and only schoolchildren aged 6–18 years), and patients who developed SLE during childcare were excluded. Next, to evaluate the effect of the timing relationship between SLE onset and childcare, we restricted the analysis to patients who were raising children, with SLE onset during childcare as the exposure. The outcomes were QOL (HRQOL, non-HRQOL, and each domain of the Lupus PRO) in both analyses. Multiple regression analysis was performed using patient age, number of children, SLICC/ACR Damage Index, cohabitation with spouse, and caregiving as confounding factors. The missing values were complemented using multiple imputations.

Results A total of 695 participants (mean age, 42.3 years, mean disease duration, 13.5 years) were included. Among them, 113 had SLE onset before childcare (67 with infants and 46 with schoolchildren only), 64 developed SLE during childcare (1 with infants and 63 with schoolchildren only), and 518 did not receive childcare. Patients who gave birth and raised infants during treatment showed significantly better cognition scores (memory and concentration) than those who were not performing childcare (regression coefficient 11.5, 95% CI 0.4–22.7, p=0.042). Patients who developed SLE while raising their children also had significantly higher social support scores than those who had the disease before starting childcare (regression coefficient 8.5, 95% CI 0.69–16.3, p=0.033).

Conclusions The presence of an infant was associated with good cognitive function in patients with SLE who were raising children while undergoing treatment. In contrast, patients who developed SLE while raising their children received better support from their families and friends. Our findings may help reduce anxiety in patients with SLE regarding pregnancy, childbirth, and subsequent childcare.