Pregnancy outcomes in Takayasu arteritis patients

Objectives: To investigate the pregnancy outcomes of patients with Takayasu arteritis (TAK) and identify the relevant risk factors. Methods: A total of 110 pregnancies in 80 patients in a Chinese TAK cohort and 550 matched pregnancies in healthy women between 2000 and 2020 were included. The pregnancy outcomes between patients and controls were compared by Fisher ' s exact test. Logistic regression analysis was used to identify risk factors for adverse pregnancy outcomes and maternal complications in patients with TAK. Results: In this case-control study, our results have demonstrated that adverse pregnancy outcomes are more frequent in TAK patients than those in healthy women (P < 0.001). The most common maternal complication was new-onset or worsening hypertension (18.2% [20/110]), and the most prevalent fetal complication was spontaneous abortion (32.7% [36/110]). Adverse pregnancy outcomes were significantly associated with hypertension (adjusted OR 2.67 [95% CI, 1.02-6.98]), renal artery involvement (adjusted OR 2.87 [95% CI, 1.10-7.51]) before pregnancy, and active disease during pregnancy (adjusted OR 11.64 [95% CI, 1.45-93.28]). The increased maternal complications were significantly associated with hypertension (adjusted OR 5.21 [95% CI, 1.70-15.95]), renal artery involvement (adjusted OR 5.36 [95% CI, 1.73-16.58]), heart disease (adjusted OR 7.96 [95% CI, 1.21-52.47]) and active TAK (adjusted OR 9.72 [95% CI, 2.58-36.65]) before pregnancy. Use of antiplatelet agents during pregnancy was associated with a reduced risk of maternal complications (adjusted OR 0.36 [95% CI, 0.13-0.97]). Conclusion: Maternal and fetal complications are associated with TAK. Effective control of TAK disease activity, surgical correction of renal artery stenosis, tight control of hypertension, use of antiplatelet agents, and close monitoring by physicians are important to improve pregnancy outcomes.