American College of Rheumatology Annual Meeting

American College of Rheumatology Annual Meeting

Source:

Gorman A. Abstract 1728. Presented at: ACR Convergence 2021; November 5-9, 2021 (virtual meeting).

Disclosures: Gorman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
November 16, 2021
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Cesarean delivery, low birth weight top pregnancy complications in Takayasu arteritis

Source:

Gorman A. Abstract 1728. Presented at: ACR Convergence 2021; November 5-9, 2021 (virtual meeting).

Disclosures: Gorman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Takayasu arteritis in pregnant patients is associated with a high prevalence of adverse outcomes for both the parent and the fetus, topped by risks for caesarean sections and low birth weight, according to meta-analysis data presented here.

“The incidence of Takayasu arteritis tends to occur in patients between the ages of 15 and 40, with 90% of patients being diagnosed under the age of 30,” Áine Gorman, MBChB, of St. Vincent’s University Hospital, in Dublin, Ireland, told attendees at ACR Convergence 2021. “Nine out of 10 with Takayasu arteritis are female. Because of this, pregnancy is an important aspect of managing Takayasu arteritis.”

pregnant woman in bed
“Ideally, Takayasu’s arteritis should be well controlled prior to pregnancy, and pregnancy planning is an important aspect when meeting with patients,” Áine Gorman, MBChB, said at a press conference. Source: Adobe Stock

“Because of the rarity of Takayasu arteritis, the impact it has on pregnancy, and the impact pregnancy has on Takayasu arteritis, is difficult to assess,” she added. “Some studies have suggested there is no increase in fetal and maternal adverse effects in patients with Takayasu arteritis during pregnancy, whereas other studies have suggested there is a 13-fold increase in the instance of maternal and fetal adverse effects. Complications include low birth weight, miscarriages, preeclampsia and intrauterine growth restriction.”

To examine the prevalence of parent and fetal outcomes in pregnant patients with Takayasu arteritis, Gorman and colleagues conducted a systemic review and meta-analysis. The researchers identified and reviewed 6,638 abstracts using Medline, Web of Science and the Cochrane library, from inception to March 26. Among these abstracts, 23 articles with reported pregnancy outcomes in patients with Takayasu arteritis were included in the final analysis.

The researchers analyzed demographic information, parent and fetal outcomes, prednisone use and disease activity data from the studies. Article selection, data extraction and bias assessment were performed by two authors working independently.

According to the researchers, there was an 11% (7% to 16%) miscarriage rate and a 1% (0% to 3%) intrauterine death rate among patients in the studies. In addition, preeclampsia was reported in 10% (7% to 12%) of patients, while preterm delivery occurred in 15% (12% to 19%). New hypertension during pregnancy was reported in 12% (8% to 16%) of patients, and intrauterine growth restriction occurred in 16% (10% to 21%).

The meta-analysis also revealed a 28% (22% to 28%) prevalence of caesarean sections among patients with Takayasu arteritis. Vasculitis flares occurred in 11% (8% to 15%) of patients. Regarding fetal outcomes, low birth weight was associated with 16% (10% to 21%) of live births.

“This study highlighted the prevalence of both maternal and fetal complications,” Gorman said. “It reinforces the belief that a multidisciplinary approach must be taken when managing pregnancy in women with Takayasu arteritis in order to achieve the best outcomes for both the mother and the baby. It reinforced the fact that blood pressure monitoring is of utmost importance during the pregnancy and physicians must keep an accurate eye on patients to ensure that they aren’t developing signs of preeclampsia.”

“Ideally, Takayasu arteritis should be well-controlled prior to pregnancy, and pregnancy planning is an important aspect when meeting with patients,” she added. “This study gives a more accurate representation of the actual prevalence of both maternal and fetal of the outcomes in patients with Takayasu arteritis.”