IMPACT OF CHILDCARE ON PATIENT-REPORTED OUTCOME IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A CROSS-SECTIONAL STUDY FROM THE LUPUS REGISTRY OF NATIONWIDE INSTITUTION (LUNA) COHORT
Bibliographic record
Abstract
O067 / #277 Topic: AS21 - Pregnancy and Reproductive Health ABSTRACT CONCURRENT SESSION 11: PREGNANCY IN SLE 24-05-2025 10:40 AM - 11:40 AM Background/Purpose Systemic lupus erythematosus (SLE) often develops at a young age leading to concerns regarding pregnancy, childbirth, and childcare. Although recent advances in treatment have increased safety during childbirth, the situation of patients with SLE raising children alongside their treatment is unknown. The quality of life (QOL) in healthy individuals tends to decline from the postpartum to the parenting period. However, the burden of parenting may be greater in patients with SLE than in healthy individuals because of perinatal relapse and child-rearing difficulties due to fatigue and functional impairment. In this study, we examined the impact of childcare on the QOL of patients with SLE. Methods This cross-sectional study used data from a multicenter SLE registry, the lupus registry of nationwide institution (LUNA). We excluded female patients with a confirmed parenting status, those within 8 weeks postpartum, those with cancer, and those whose child’s age could not be confirmed. First, to evaluate the impact of childcare on patients’ QOL during treatment, the exposure was parenting, divided into 2 categories (including infants aged 0–5 years and only schoolchildren aged 6–18 years), and patients who developed SLE during childcare were excluded. Next, to evaluate the effect of the timing relationship between SLE onset and childcare, we restricted the analysis to patients who were raising children, with SLE onset during childcare as the exposure. The outcomes were QOL (HRQOL, non-HRQOL, and each domain of the Lupus PRO) in both analyses. Multiple regression analysis was performed using patient age, number of children, SLICC/ACR Damage Index, cohabitation with spouse, and caregiving as confounding factors. The missing values were complemented using multiple imputations. Results A total of 695 participants (mean age, 42.3 years, mean disease duration, 13.5 years) were included. Among them, 113 had SLE onset before childcare (67 with infants and 46 with schoolchildren only), 64 developed SLE during childcare (1 with infants and 63 with schoolchildren only), and 518 did not receive childcare. Patients who gave birth and raised infants during treatment showed significantly better cognition scores (memory and concentration) than those who were not performing childcare (regression coefficient 11.5, 95% CI 0.4–22.7, p=0.042). Patients who developed SLE while raising their children also had significantly higher social support scores than those who had the disease before starting childcare (regression coefficient 8.5, 95% CI 0.69–16.3, p=0.033). Conclusions The presence of an infant was associated with good cognitive function in patients with SLE who were raising children while undergoing treatment. In contrast, patients who developed SLE while raising their children received better support from their families and friends. Our findings may help reduce anxiety in patients with SLE regarding pregnancy, childbirth, and subsequent childcare.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".