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Despite good outcomes, women with Takayasu arthritis fear pregnancy complications
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Although pregnancy-related concerns are common in patients with Takayasu arteritis, maternal and fetal outcomes appear to be good overall, according to findings
In the population-based study, researchers enrolled 58 women with Takayasu arthritis (TAK), primarily recruiting from a population-based southeast Norway TAK cohort. From medical charts, patient questionnaires and the Medical Birth Registry of Norway (MBRN), researchers extracted data on the number of pregnancies, births and pregnancy outcomes before and after TAK onset. Patient questionnaires were used to retrieve data on pregnancy-related concerns.
There were 110 pregnancies, 73 before TAK onset and 37 after disease onset. No disparities were seen between pregnancies occurring before vs. after TAK onset in the prevalence of miscarriages, induced abortions, and material complications. In 4.2% of patients who gave birth after TAK onset, pregnancy-related hypertension was documented vs. 1.5% of women in the MBRN reference cohort. Similarly, pre-eclampsia/eclampsia was seen in 4.5% of women in the TAK cohort vs. 3% in the MBRN reference cohort. After TAK onset, the mean gestational age at delivery was 37.5 weeks vs. 39.5 weeks in the reference cohort. Deliveries that occurred after TAK onset resulted in a higher prevalence of Cesarean sections (42%) vs. the MRBN reference cohort (11%).
A total of 43 women (80%) in the TAK cohort noted at least one pregnancy-related concern. Of the 12 patients who had never been pregnant and responded to the questionnaires, nine had concerns pertaining to potential pregnancy complications and six were concerned about passing the disease on to children. Four of these patients stated they had been advised against pregnancy by a physician and seven said TAK was the reason they had not had children.
“Pregnancy outcomes in our population-based cohort, which had few occurrences of renal artery stenosis and with the majority of the pregnancies planned and patients receiving close interdisciplinary follow-up when pregnancy was confirmed, was quite good,” the researchers wrote. “Nevertheless, fear of pregnancy-related complications among patients with TAK was very prevalent and probably resulted in reduced family sizes.” -by Jennifer Byrne
Disclosures: The researchers report no relevant disclosures.
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Gudbrandsson B, et al. Arthritis Care & Res. 2017;doi: 10.1002/acr.23146
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