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

Abstract

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.

Poor obstetric outcomes in women with takayasu arteritis: a retrospective cohort study

“…Our study found only six TA patients (6.8%) who developed preeclampsia and one patient eclampsia in striking contrast to the literature report of up to 75.9% in the preeclampsia/eclampsia rate [ 6 , 20 – 22 ]. The low incidence of eclampsia/preeclampsia in our study may be due to the effective management of hypertension and TA disease before and following pregnancy.…”

“…In this study, our results have shown that the main complications associated with TA are new-onset or worsening hypertension for mothers and preeclampsia, abortion, low birth weight prematurity, and in utero death for fetuses. Inconsistencies within the literature exist regarding the report of maternal complications and fetal outcomes associated with TA in distinct studies [ 6 , 19 ]. Hypertension is the most common maternal complication in women with TA, with incidence rates ranging from 5.3% to 100% [ 6 , 19 ].…”

“…Inconsistencies within the literature exist regarding the report of maternal complications and fetal outcomes associated with TA in distinct studies [ 6 , 19 ]. Hypertension is the most common maternal complication in women with TA, with incidence rates ranging from 5.3% to 100% [ 6 , 19 ]. Our study, which used a large sample size, confirmed the previous report with an incidence of 62.9% in our study.…”

Pregnancy outcomes in Takayasu arteritis patients: a systematic review and meta-analysis

“…On the other hand, advanced maternal age or prolonged disease duration did not predispose to obstetric complications 8 . Gönenli et al, also reported that maternal age did not oppose as risk factor for poor pregnancy outcomes, in contrast to vascular damage, and recent diagnosis, commonly associated with uncontrolled inflammation and high disease activity 40 .…”

“…On the other hand, advanced maternal age or prolonged disease duration did not predispose to obstetric complications 8 . Gönenli et al, also reported that maternal age did not oppose as risk factor for poor pregnancy outcomes, in contrast to vascular damage, and recent diagnosis, commonly associated with uncontrolled inflammation and high disease activity 40 . www.nature.com/scientificreports/ New onset and/or aggravation of hypertension appear to be the main maternal complications in our analysis, which concurs with previous studies 8 .…”