Objective: Systemic vasculitis (SV) are uncommon diseases that rarely affect women during their reproductive age; little data, mainly retrospective, is available on this topic. The aim of our study was to evaluate maternal/neonatal outcome and disease course before, during and after pregnancy. Methods: Sixty-five pregnancies in 50 women with SV were followed by a multispecialistic team in 8 institutions between 1995 and 2014. Clinical data on pregnancy, 1. year before and 1. year after delivery was retrospectively collected. The rate of pregnancy complications was compared to that of a General Obstetric Population (GOP) of 3939 women. Results: In 2 patients the diagnosis of SV was done during pregnancy; 59 out of the remaining 63 started when maternal disease was quiescent. We recorded 56 deliveries with 59 live births, 8 miscarriages and 1 fetal death. In SV, preterm, particularly early preterm (<. 34. weeks) deliveries and cesarean sections appeared significantly more frequent than in GOP (11.3% vs 5.0%, p=. 0.049 and 48.2% vs 31.0%, p=. 0.009).Vasculitis-related complications occurred in 23 pregnancies (35.4%), with 5 severe events (7.7%) including 3 cases of transient ischemic attack (TIA). Data about the post-partum period were available for 56 pregnancies: 12 flares (21.4%) occurred, with 1 severe event (1.8%). Conclusion: SV patients can have successful pregnancies (especially during a disease remission phase) despite an increased rate of preterm delivery. Severe flares were limited, but the occurrence of 3 TIA suggests that particular attention should be given to possible thrombotic complications in SV patients during pregnancy and puerperium.
Systemic vasculitis and pregnancy: A multicenter study on maternal and neonatal outcome of 65 prospectively followed pregnancies / M. Fredi, M.G. Lazzaroni, C. Tani, V. Ramoni, M. Gerosa, F. Inverardi, P. Sfriso, P. Caramaschi, L. Andreoli, R.A. Sinico, M. Motta, A. Lojacono, L. Trespidi, F. Strigini, A. Brucato, R. Caporali, A. Doria, L. Guillevin, P.L. Meroni, C. Montecucco, M. Mosca, A. Tincani. - In: AUTOIMMUNITY REVIEWS. - ISSN 1568-9972. - 14:8(2015 Aug), pp. 686-691. [10.1016/j.autrev.2015.03.009]
Systemic vasculitis and pregnancy: A multicenter study on maternal and neonatal outcome of 65 prospectively followed pregnancies
M. Gerosa;L. Trespidi;A. Brucato;R. Caporali;P.L. Meroni;
2015
Abstract
Objective: Systemic vasculitis (SV) are uncommon diseases that rarely affect women during their reproductive age; little data, mainly retrospective, is available on this topic. The aim of our study was to evaluate maternal/neonatal outcome and disease course before, during and after pregnancy. Methods: Sixty-five pregnancies in 50 women with SV were followed by a multispecialistic team in 8 institutions between 1995 and 2014. Clinical data on pregnancy, 1. year before and 1. year after delivery was retrospectively collected. The rate of pregnancy complications was compared to that of a General Obstetric Population (GOP) of 3939 women. Results: In 2 patients the diagnosis of SV was done during pregnancy; 59 out of the remaining 63 started when maternal disease was quiescent. We recorded 56 deliveries with 59 live births, 8 miscarriages and 1 fetal death. In SV, preterm, particularly early preterm (<. 34. weeks) deliveries and cesarean sections appeared significantly more frequent than in GOP (11.3% vs 5.0%, p=. 0.049 and 48.2% vs 31.0%, p=. 0.009).Vasculitis-related complications occurred in 23 pregnancies (35.4%), with 5 severe events (7.7%) including 3 cases of transient ischemic attack (TIA). Data about the post-partum period were available for 56 pregnancies: 12 flares (21.4%) occurred, with 1 severe event (1.8%). Conclusion: SV patients can have successful pregnancies (especially during a disease remission phase) despite an increased rate of preterm delivery. Severe flares were limited, but the occurrence of 3 TIA suggests that particular attention should be given to possible thrombotic complications in SV patients during pregnancy and puerperium.File | Dimensione | Formato | |
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