THE FIRST 1000 DAYS OF LIFE AND REPRODUCTIVE DISORDERS IN WOMAN WITH RHEUMATIC DISEASE (RDS)

Background: Gynaecological problems are often ignored by rheumatologist andhave a negative impact on quality of life of RDs patients.Objectives: The aim of this study was to describe gynaecological, reproductiveand sexual problems in premenopausal woman with RDs.Methods: A monocentric, cross-sectional observational study was conducted inthe Rheumatology Department of Careggi Hospital in Florence. Inclusion criteria:female gender, premenopausal age (and≥18 years old), diagnosis of rheumaticdiseases. All patients have been investigated about gynaecological anamnesisand symptoms and subjected to a self-administered validated questionnaire.Results: From May 4 th to November 30th, 2020, 200 patients were enrolled(mean age 39.1± 8.7 years (M±SD)): 58% arthritis, 40% connective tissue disease and 1.5% systemic vasculitis. In the history, spontaneous, full-term birth in91% and 93% of patients, respectively, was observed and pre-term birth wasreported in 8.1%. 63% of patients were breastfed. In family history, menorrhagia, dysmenorrhea, or chronic pelvic pain were reported in 59%, 55 and 7% ofpatients, respectively. The first menstruation was at 12.3±2.0 years (M±DS) andmostly woman reported menstrual disorders during adolescence (56% experienced dysmenorrhea and 52% menorrhagia). Menstrual disorders and abnormalbleeding were frequently reported also in adulthood: 71% had dysmenorrhea,38% heavy menstrual cycles and 9% metrorrhagia. Moreover, 26% of patientsreferred non- menstrual pelvic pain, 19% urinary pain and 18% pain during defecation. Vaginal symptoms were frequently reported: 36% of patients referredvaginal dryness, 29% burning, 19% recurrent vaginal infections and dyspareuniain 39% of patients. Uterine fibroma was present in 23% and endometriosis in10% of patients. Fertility problems were reported by 10% of patients in a timeframe of 7.5±6.4 years and 30% of patients experienced at least one miscarriage;otherwise, 56% of patients have had at least one full-term pregnancy.Conclusion: RDs patients show a high prevalence of various gynaecologicalproblems affecting their quality of life. The management of female RDs patientsis a challenge for the clinician and should include an accurate evaluation of thegynaecological aspects (menstruation, fertility, maternity, sexuality) as well as amultidisciplinary teamwork (rheumatologist and gynaecologists).