Considering Pregnancy: Duality in the Reproductive Journey and Decision-Making in Hispanic Women With Systemic Lupus Erythematosus in the United States

考虑怀孕:美国患有系统性红斑狼疮的西班牙裔女性在生育历程和决策中的双重性

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Abstract

OBJECTIVE: Systemic lupus erythematosus (SLE) commonly affects women during their childbearing years, making pregnancy experiences especially important to understand. This is particularly true for US Hispanic women, who face a higher SLE burden, more unplanned pregnancies, and frequent language or cultural discordance with clinicians. This study explores their perspectives, focusing on emotional dualities, logistical challenges, and views on unplanned pregnancies. METHODS: We conducted semistructured interviews with 30 Hispanic women aged 18 to 45 with SLE, recruited from Los Angeles General Medical Center and LupusLA. Eligible participants were heterosexually active or considering pregnancy within three years. Interviews were analyzed using grounded theory to identify themes related to pregnancy experiences, whether actual or hypothetical. RESULTS: Three core themes emerged: (1) pregnancy with SLE was marked by a variety of emotions (primarily hope and anxiety); (2) navigating frequent appointments and complex care created logistical strain but also reassurance; and (3) unplanned or poorly timed pregnancies led to a desire for immediate, trusted guidance from their rheumatologist, with most participants preferring continuation if medically feasible. CONCLUSION: Findings highlight the emotional complexity and logistical challenges faced by Hispanic women with SLE. Many of the themes mirror those seen in other chronic disease populations, underscoring that US Hispanic women with SLE, their cultural and linguistic barriers notwithstanding, share many of the same hopes, fears, and needs as other women navigating pregnancy with chronic illness. These results emphasize the need for empathetic, patient-centered reproductive health care that addresses their emotional, medical, and informational needs.

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