Systemic vasculitis and pregnancy: A multicenter study on maternal and neonatal outcome of 65 prospectively followed pregnancies

作者：Fredi Micaela; Lazzaroni Maria Grazia; Tani Chiara; Ramoni Veronique; Gerosa Maria; Inverardi Flora; Sfriso Paolo; Caramaschi Paola; Andreoli Laura; Sinico Renato Alberto; Motta Mario; Lojacono Andrea; Trespidi Laura; Strigini Francesca; Brucato Antonio; Caporali Roberto; Doria Andrea; Guillevin Loic; Meroni Pier Luigi; Montecucco Carlomaurizio; Mosca Marta; Tincani Angela^*

来源：Autoimmunity Reviews, 2015, 14(8): 686-691.

DOI：10.1016/j.autrev.2015.03.009

• Pregnancy
• Systemic vasculitis

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.

• 出版日期2015-8