Women with lupus can and do have healthy pregnancies, but planning ahead is key. That’s because it’s important to make sure your condition is well-controlled before conceiving and that you’re not taking a medication that has been associated with a high risk of birth defects.
If you have lupus and are not currently planning to conceive, being on prescription or long-acting birth control (such as an IUD) is a smart way to avoid an “oops” pregnancy and the associated health risks for both expectant moms and babies.
While many women with lupus are, in fact, using a reliable form of birth control, many others are not. And a new study suggests that the patient’s race might have something to do with it.
In the study, which was published in the journal Arthritis Care & Research, researchers from Brigham and Women’s Hospital and Harvard Medical School analyzed 10 years’ worth of Medicaid claims data to learn about the likelihood of women with lupus receiving contraception from a health care provider. They were able to access info on nearly 25,000 female lupus patients of reproductive age (ages 18-50) who were insured by Medicaid between 2000 and 2010.
According to their findings, 9 percent of these women had a visit with a health care provider to discuss contraception, but only 2 percent actually received “highly effective contraception” (HEC) such as an implant, injectable contraceptive, IUD, or oral birth control pills. They also determined that white women with lupus were the most apt to get HEC from a health care provider.
“Compared to white women, Black and Asian women had lower odds of contraception dispensing, and Black women had lower odds of HEC use,” the authors wrote.
This discrepancy is especially concerning given that Black and Hispanic women with lupus face a higher risk of pregnancy complications, study co-author Candace H. Feldman, MD, MPH, ScD, told Healio Rheumatology.
“Lupus disease severity is also higher among Black women and this often requires use of teratogenic medications” that carry a high risk of birth defects, she said.
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Laday J. Black, Asian Women With Lupus Less Likely Than White Patients to Receive Contraception. Healio Rheumatology. July 7, 2020. https://www.healio.com/news/rheumatology/20200707/black-asian-women-with-lupus-less-likely-than-white-patients-to-receive-contraception.
Williams JN, et al. Racial Differences in Contraception Encounters and Dispensing Among Female Medicaid Beneficiaries with Systemic Lupus Erythematosus. Arthritis Care & Research. June 11, 2020. doi: https://doi.org/10.1002/acr.24346.