Behcet’s disease and pregnancy: what to expect?

Abstract

The relationship between Behcet's disease (BD) and pregnancy is only reported in limited number of studies. We retrospectively collected data of 26 women with BD diagnosis and their 66 pregnancies. We analysed patients according to disease activity, age at BD diagnosis, age at first/last pregnancy, obstetric history, obstetric complications, neonatal birthweight, associated foetal abnormalities and pregnancy-related complications. Sixteen miscarriages (24.2%), two intrauterine deaths (3%) and 48 live births (72.8%) were identified. Preterm labour was observed in 12 (24%) of 50 deliveries. Colchicine was used in six pregnancies, however, there was no drug treatment for BD in the remaining 59. There was a higher rate of preterm labour and low birthweight in patients using colchicine. BD was in remission in 60 (90.9%) of 66 pregnancies, and disease flared up only in six cases. In conclusion, BD patients with altered symptoms during pregnancy carry an increased risk of obstetric complications. IMPACT STATEMENT What is already known on this subject: There are limited and conflicting data about the interaction between BD and gestation. What the results of this study add: Our findings indicated that patients who were in an active symptomatic phase of BD and were being treated with colchicine had an increased risk of preterm delivery and low birthweight. What the implications are of these findings for clinical practice and/or further research: Clinicians should consider increased obstetric complication risk among patients with active BD.

Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies

“…), which may cause impaired fetal perfusion and result in fetal death (17). Adverse outcomes were reported in autoimmune diseases such as Behcet disease, Celiac disease, inflammatory bowel diseases, Systemic lupus erythematosus (SLE) and Hashimoto's thyroiditis (18)(19)(20)(21). MTHFR polymorphisms are also related to poor perinatal outcome and necessitate special antenatal care (12,22).…”

Retrospective evaluation of pregnancies with ankylosing spondylitis in a tertiary center in Turkey

“…Autoimmune disorders and diseases resulting in chronic systemic inflammation have been linked with poor obstetric outcomes in various studies . Requirement for medical treatment including biological agents was also found to contribute to poor obstetric outcomes .…”

“…Requirement for medical treatment including biological agents was also found to contribute to poor obstetric outcomes . Excessive activation of the immune system may lead to impaired implantation and impaired fetal perfusion, which is also related to poor obstetric outcomes . Autoimmune antibodies, cell degradation products and inflammatory cytokines were reported to be responsible for injury to vascular structures of the placenta and cellular components of the maternal fetal interface, resulting in “placental inflammation” .…”

“…Some studies have shown that AS may be associated with adverse pregnancy and neonatal outcomes including preterm labor and small‐for‐gestational age (SGA) fetuses . Furthermore, autoimmunity or autoimmune diseases were also reported to be associated with adverse outcomes …”

Psoriasis and Pregnancy: Retrospective Evaluation of 47 Pregnancies in a Tertiary Center

“…The relationship between autoimmune diseases and adverse pregnancy outcomes were reported in various studies (18)(19)(20)(21). Autoimmune antibodies, cell degradation products and inflammatory cytokines were most likely responsible for the injury to vascular structures of the placenta and cellular components of the maternal�fetal interface, resulting in "placental inflammation".…”