163. Pregnancy Risk, Teratogen Use, and Estrogen Contraindications among an Adolescent and Young Adult Rheumatology Population

Unintended pregnancy among adolescents and young adults (AYAs) with rheumatic disease has higher risk to mother fetus through the itself, contraindications estrogen, high rates of teratogen use. However, because diseases are uncommon, few samples large enough describe risks. Our purpose was risk, use, estrogen AYAs disease. ages 14-26 assigned female at birth were recruited from outpatient pediatric rheumatology clinics a Midwest tertiary care center associated outreach clinics. Participants completed one-time online survey assessing history sexual reproductive health behaviors, including activity contraceptive Diagnosis, severity, medication use extracted electronic medical record. systemic lupus erythematosus (SLE), mixed connective tissue (MCTD), primary antiphospholipid antibody syndrome (APS), or Takayasu arteritis (TAK) considered have disease-related risk. Medications classified as teratogens (eg, methotrexate, mycophenolate, cyclophosphamide, etc.) non-teratogens. The American College Rheumatology (ACR) guidelines for CDC eligibility criteria (MEC) used classify patients having possible (any positive antibodies controlled hypertension) definite (persistently classic APLs, migraines aura, contraindications. We provide descriptive statistics. 113 participants 14-23 years old (mean=16.8y, S.D.=2.0). One self-identified transmale 5 nonbinary/other (n=6; 5%) 19% (n=21) LGBTQ+. Ethnicities included 12% Black (n=13), 8% Latinx (n=9), 3% Asian (n=3). Diseases juvenile idiopathic arthritis (48%; n=54), SLE 16% (n=18), MCTD 4% (n=4), APS 1% (n=1), TAK (n=1). Teratogenic 38% (n=43). Vaginal sex reported by 21% (n=24). Among all participants, (n=5) LARC (IUD, implant) 24% (n=27) effective hormonal methods (pills, patch, ring, shot). those using teratogenic medications, (n=8) methods, 9% (n=4) condoms only, 72% (n=31) no method. reporting vaginal sex, risks had lower (43%, n=3) than without (76%, n=13, p=NS). About half method n=3). similar between on medications (60%, not (68%, Of note, 40% (n=2) only condoms. 10% (n=11) 7% None containing contraceptives. sexually experienced that general population. Sexually more likely contraception. This is an opportunity providers educate advocate appropriate in this high-risk