Objectives To examine possible influence of quality of life domains in women with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) not achieving pregnancy.

Methods Data from RevNatus, a Norwegian nationwide observational register of women with rheumatic diseases planning pregnancy was used. We compared women with SLE and RA who did and did not achieve pregnancy during follow-up. Fifty-three women with SLE and 180 women with RA with a pregnancy wish had follow-up until pregnancy and known pregnancy outcome or at least one year if not achieving pregnancy. We assessed quality of life (QoL) using RAND-36. A higher score indicates a better QoL. A change in score of 3–5 points is considered a minimal clinically important difference (MCID).

Results During follow-up 47 (88.7%) SLE- women and 130 (72.2%) RA-women conceived, while 6 (11.3%) SLE-women and 50 (27.8%) RA-women did not. In women with SLE not achieving pregnancy (NAP), a higher frequency were nulliparous, smoked, had active disease or overweight compared to SLE women achieving pregnancy (AP). Women with RA not achieving pregnancy were older and had experienced preeclampsia more often than women with RA achieving pregnancy. Women with SLE not achieving pregnancy compared to SLE-women achieving pregnancy had lower mean QoL-scores (MCID) in all domains except for bodily pain, which was higher. Women with RA had generally lower QoL than women with SLE in the domains physical role, bodily pain and global health whether or not conceiving. The women with RA not achieving pregnancy had higher QoL-scores on bodily pain and lower scores on emotional role, but not differences in scores of clinical relevance in the other domains of QoL compared to RA-women achieving pregnancy (table 1).

Conclusions Reduced quality of life may contribute to not achieving pregnancy in both women with SLE and women with RA.