Background: The impact of rheumatic diseases (RDs) on the Quality of Life (QoL) of antenatal women remains underexplored. This study aimed to investigate health-related QoL among pregnant and breastfeeding women with RDs in comparison to their healthy counterparts, utilizing data from the COVAD-2 e-survey database.

Objectives: To assess health-related QoL using Patient-Reported Outcome Measurement Information System (PROMIS) instruments, focusing on Global Physical Health (GPH) and Global Mental Health (GMH) scores. Comparative analyses were conducted among four groups: 1) Non-pregnant/breastfeeding healthy, 2) Non-pregnant/breastfeeding RDs, 3) Pregnant/breastfeeding healthy, and 4) Pregnant/breastfeeding RDs. The study sought to identify factors influencing GPH and GMH scores within each group.

Methods: Demographic information, diagnosis of RDs, comorbidities, disease activity, and treatments were analyzed using data from the COVAD-2-e-survey database. GPH, and GMH scores were compared among the four groups, and multivariable regression analysis was employed to identify the factors affecting GPH and GMH scores within each group.

Results: After excluding missing values, our analysis encompassed 2931 cases across four groups: 1) Non-pregnant/breastfeeding healthy (1337 cases), 2) Non-pregnant/breastfeeding RDs (1459 cases), 3) Pregnant/breastfeeding healthy (77 cases), and 4) Pregnant/breastfeeding RDs (58 cases).

The General Physical Health (GPH) median score peaked in the pregnant/breastfeeding healthy group (17 [10-20]), contrasting with the lowest score observed in Non-pregnant/breastfeeding RDs (14 [4-20]) (Figure 1). Among RD patients, pregnant/breastfeeding groups exhibited significantly higher GPH scores compared to non-pregnant/breastfeeding groups (p=0.01), an observation absent in healthy controls. Influencing factors in RDs included ethnicity, with Caucasians showing better scores than Asians (p=0.017), pregnant/breastfeeding status (p=0.002), concomitant comorbidities (p=0.041), and mental disorders (p=0.001).

Similarly, the General Mental Health (GMH) median score was highest in the pregnant/breastfeeding healthy group (17 [4-20]) and lowest in Non-pregnant/breastfeeding RDs (15 [4-20]) (Figure 1). Pregnant/breastfeeding RDs groups exhibited significantly higher GMH scores than their non-pregnant/breastfeeding counterparts (p=0.003), a distinction not observed in healthy controls. Influencing factors in RDs included ethnicity, with Caucasians showing better scores than African Americans (p=0.000) or Asians (p=0.025), pregnant/breastfeeding status (p=0.001), and concomitant mental disorders (p=0.000).

Conclusion: Women with RDs exhibit better mental and physical QoL during the antenatal period than their non-pregnant/breastfeeding counterparts—a distinction not observed in healthy controls, possibly as disease is planned in safe periods or goes into remission during antenatal period and this is reassuring. Ethnicity, comorbidities, and mental disorders have a substantial impact on QoL in this demographic, calling for targeted healthcare interventions that acknowledge the unique features of women of childbearing age with RDs. Further, these observations call for long term prospective international studies to comprehensively address the aspects of QoL in this specific demographic, enabling the development of more informed and personalized healthcare strategies.

REFERENCES: NIL.

Figure 1.

Comparison of Global Physical Health (GPH) scores and Global Mental Health (GMH) scores within four groups: 1) Non-pregnant/breastfeeding healthy, 2) Non-pregnant/breastfeeding RDs, 3) Pregnant/breastfeeding healthy, and 4) Pregnant/breastfeeding RDs.

Acknowledgements: NIL.

Disclosure of Interests: None declared.