Takayasu arteritis increases risk for adverse pregnancy outcomes
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Pregnant patients with Takayasu arteritis demonstrate an increased risk for adverse pregnancy outcomes, including hypertension and miscarriage, compared with the general population, according to a meta-analysis published in Nature.
“It is widely recommended that women suffering from autoimmune systemic diseases need to plan their pregnancy during periods of remission or low disease activity in order to avoid unfavorable outcomes for both mother and fetus, as well as to prevent a severe relapse of the disease itself during this period,” Styliani Partalidou, MD, of Hippokration General Hospital, in Thessaloniki, Greece, and colleagues wrote. “During previous decades, young women with [Takayasu arteritis (TA)] were advised to avoid pregnancy, due to elevated risk of adverse events.”
To investigate the prevalence of adverse pregnancy outcomes in patients with Takayasu arteritis, Partalidou and colleagues conducted a systematic review and meta-analysis. The researchers conducted a search of the PubMed, Scopus, Cochrane Library and Cinahl databases for studies of adult women with Takayasu arteritis through May 25, 2022. Non-English language studies and those with patients who demonstrated other types of systemic vasculitides were excluded.
The researchers assessed study data including first author, publication, country, study type, number of patients and pregnancies, diagnostic criteria, average disease duration, medication and miscarriage, cesarean section, preterm delivery, hypertension, preeclampsia and intrauterine growth restriction (IUGR) neonate rates. The outcomes of interest were miscarriages, hypertension and preeclampsia rates.
The analysis included 27 studies representing 825 pregnancies. In this series, the rate of miscarriage in patients with Takayasu arteritis was 16% (95% CI, 12% to 21%), according to the researchers. Patients in this group also demonstrated a hypertension rate of 37% (95% CI, 30%-45%) and a preeclampsia rate of 14% (95% CI, 8-23%).
Meanwhile, large-scale reviews of the general population show miscarriage, hypertension and preeclampsia rates of 15%, 5% to 10%, and 3%, respectively, the researchers wrote.
“Our study estimated high rates of hypertension, miscarriage, and pre-eclampsia in TA pregnant women,” Partalidou and colleagues wrote. “These findings indicate that women with TA are at higher risk of adverse pregnancy outcomes than in general population. Thus, more intense follow-up along with multidisciplinary approach is needed for these patients to reach an optimal delivery.
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