Pregnancy issues in Takayasu arteritis

Comarmond, Cloé; Saadoun, David; Nizard, J.; Cacoub, P.

doi:10.1016/j.semarthrit.2020.08.001

Cited by 16 publications

(14 citation statements)

References 28 publications

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“…A higher risk of gravid hypertensive disorders is found among patients with Takayasu arteritis, as previously observed. 2,5,19,20 In our study, vasculitides flare, approximated as an increase in glucocorticoid daily dose, is also associated with hypertensive disorders during pregnancy. However, the association between glucocorticoid use and arterial hypertension is well known and seems to exist among pregnant women.…”

Section: Discussionsupporting

confidence: 50%

“…[15][16][17][18] However, to our knowledge, no study has assessed factors associated with PTB in systemic vasculitides. Among the common causes of PTB, hypertensive disorders, ie, gravid hypertension, pre-eclampsia, hemolysis elevated liver enzymes and low platelet count (HELLP) syndrome, and eclampsia, are frequent obstetrical complications in patients with Takayasu arteritis, 5,19,20 polyarteritis nodosa, 21 antineutrophil cytoplasmic antibody-associated vasculitides, 22,23 and IgA vasculitides. 24,25 To date, risk factors associated with hypertensive disorders among pregnant women affected with systemic vasculitides are not known.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women With Systemic Vasculitides: A Nationwide Population‐Based Cohort Study

Mettler,

Beeker,

Collier

et al. 2024

Arthritis & Rheumatology

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IntroductionEven though systemic vasculitides (SV) affect primarily patients over 50 years of age, they can occur among women of childbearing age. Preterm birth (PTB) and hypertensive disorders are frequent complications of pregnancy in SV. This study aims to evaluate the risk of hypertensive disorders and PTB amongst pregnant women with SV, and to identify associated risk factors.MethodUsing the French health insurance data warehouse, we conducted a nationwide cohort study including all pregnancies between 2013 and 2018 in women with SV. Theses pregnancies were matched to pregnancies among women without SV. We estimated hypertensive disorders’ risk and PTB risk during pregnancy among women with SV and we investigated associated risk factors using a nested case‐control design.ResultsAmid 3,155,723 pregnancies, we identified 646 pregnancies in women with SV, matched to 3,230 controls. SV were significantly associated with hypertensive disorders (OR 1.7, 95% CI [1.3‐2.2]) and PTB (OR 1.8, 95% CI [1.4‐2.3]). Chronic renal failure before pregnancy, history of or treated arterial hypertension, the occurrence of vasculitides flare during pregnancy and the subgroup of SV were independently associated with the occurrence of hypertensive disorders. Maternal age at delivery, chronic renal failure before conception and the occurrence of vasculitides flare during pregnancy were independently associated with the occurrence of PTB.ConclusionAbout one over seven pregnancies in women with SV is associated with hypertensive disorders or preterm birth. The occurrence of vasculitides flare was associated with these complications. Our findings support the importance of pre‐pregnancy counselling to ensure disease stability.image

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women With Systemic Vasculitides: A Nationwide Population‐Based Cohort Study

Mettler,

Beeker,

Collier

et al. 2024

Arthritis & Rheumatology

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“…This result is similar to that of another study published from Turkey 22 . There were no severe complications such as heart failure and thrombosis unlike the study of Comarmond et al 12 …”

Section: Discussionmentioning

confidence: 54%

“…However, with the increase in the risk of preeclampsia/eclampsia, the risk of prematurity may be an appropriate expectation. On the other hand, in pregnancies of patients with TAK, IUGR and fetal loss rates seem to increase as well as prematurity according to some studies 12 . In fact, these fetal problems may also be associated with maternal HT‐related complications.…”

Section: Discussionmentioning

confidence: 99%

“…Some physiologic adaptive changes in the immune and cardiovascular systems during pregnancy, such as increased circulating blood volume and increased heart load, may worsen TAK‐related symptoms or disease course in pregnant women 12,13 . Different results have been obtained in studies evaluating the effects of pregnancy on the disease prognosis 14‐17 .…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy in Takayasu’s arteritis has a high risk of hypertension‐related fetomaternal complications: A retrospective study of a Turkish cohort

et al. 2021

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Background This study aimed to examine fetomaternal outcomes in pregnant women in a large Turkish Takayasu arteritis (TAK) cohort and to evaluate the effects of pregnancy on the disease in those patients. Methods This is a cohort study involving 296 pregnancies of 112 TAK patients from 8 tertiary rheumatology centers in Turkey. Pregnancies were divided into 2 groups as pre‐d (before disease onset) and post‐d (after disease onset). In addition, post‐d pregnancies were further divided into 2 subgroups according to fetomaternal complications (FMC) development status. Finally, patients were grouped into those with and without a history of pregnancy after disease onset. Results In post‐d pregnancies, rates of worsening hypertension, new‐onset hypertension, and preeclampsia were higher than in pre‐d pregnancies (0.9% vs 16%, P < .001, 0.5% vs 5.3%, P = .012, and 0% vs 4%, P = .013, respectively). Patients with FMC were more likely to have renal artery involvement (65% vs 21%, P = .003). The patients who had post‐d were younger, had longer disease duration, and had more relapses number than other patients (P < .001, P = .028, P = .016, respectively). Vasculitis Damage Index (VDI) results were similar in patients with or without post‐d pregnancies. Conclusion Pregnancies after disease onset were found to be associated with HT and preeclampsia/eclampsia. HT‐related FMCs are increased in TAK, and patients with renal artery involvement are at higher risk. The number of relapses increases in patients who become pregnant after disease onset, but pregnancy was not an independent risk factor for relapse. Pregnancy after the onset of disease had no negative effect on VDI.

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Rheumatologische Krankheiten und Schwangerschaft: Systemischer Lupus erythematodes, Antiphospholipidsyndrom, rheumatoide Arthritis, Spondyloarthritis, systemische Sklerose, entzündliche Myopathien und Vaskulitis

Förger

Mayer-Pickel

2022

Die Geburtshilfe

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Pregnancy issues in Takayasu arteritis

Cited by 16 publications

References 28 publications

Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women With Systemic Vasculitides: A Nationwide Population‐Based Cohort Study

Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women With Systemic Vasculitides: A Nationwide Population‐Based Cohort Study

Pregnancy in Takayasu’s arteritis has a high risk of hypertension‐related fetomaternal complications: A retrospective study of a Turkish cohort

Rheumatologische Krankheiten und Schwangerschaft: Systemischer Lupus erythematodes, Antiphospholipidsyndrom, rheumatoide Arthritis, Spondyloarthritis, systemische Sklerose, entzündliche Myopathien und Vaskulitis

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