Takayasu's Arteritis in Pregnancy

Ireland: Takayasu's arteritis in pregnant women is associated with a high prevalence of adverse outcomes in both mother and the fetus, necessitating meticulous therapy by a multidisciplinary team during pregnancy. This was demonstrated by a new study done by Aine Gorman and colleagues. This work was presented as a poster at Pediatric Rheumatology Symposium, ACR Convergence 2021, November 9.

Takayasu's arteritis is a systemic autoimmune illness characterized by vasculitis of major vessels. It typically affects women of reproductive age, with 90 percent of patients diagnosed before the age of 30, and past research suggests it is linked to poor pregnancy outcomes. There is a vast discrepancy within the literature; some studies suggest preeclampsia occurring in 4.5% of patients, while others suggest a rate of 61%. The purpose of this work was to determine the prevalence of both maternal and fetal outcomes in patients with Takayasu's arteritis through a systematic review and meta-analysis.

For this work, researchers conducted a systematic analysis of the literature from their inception to March 26, 2021, using Medline, Web of Science, and the Cochrane library, to find studies that reported pregnancy outcomes in patients with Takayasu's arteritis. This analysis included demographic data, maternal outcomes, fetal outcomes, prednisolone usage, and disease activity data gathered from studies. Two writers chose the research independently, extracted the data, and assessed the likelihood of bias.

The systematic review for this study included 6638 abstracts, of which 23 publications were included.

• Miscarriage rate: 11% [7-16%]
• Risk of intrauterine mortality: 1% [0-3%]
• Preeclampsia: 10% [7-12%] of patients
• Preterm birth: 15% [12-19%] of cases
• New hypertension: 12% [8-16]% of pregnant women
• Intrauterine growth limitation: 16% [10-21]% of pregnancies
• Caesarean sections: 28% [22-28]% of Takayasu patients
• Low birth weight: 16% [10-21]% of live births
• Vasculitis flares: 11% [8-15]% of patients

"There is a high prevalence of both maternal and fetal adverse outcomes in pregnant patients with Takayasu's arteritis, who require careful management by a multidisciplinary team during pregnancy," said the Authors in conclusion.

Reference

Gorman A, Rooney L, Turk M, Moore L, Bierbrier J, O'Brien C, Clohessy A, Molloy E, O Neill L, McAuliffe F, Veale D. Takayasu's Arteritis and Pregnancy: A Meta-analysis [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/takayasus-arteritis-and-pregnancy-a-meta-analysis/. Accessed November 18, 2021.