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Analysis of risk factors for complications and adverse obstetrical outcomes in women with Takayasu arteritis: a French retrospective study and literature review

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Abstract

Objective

Takayasu arteritis (TAK) is a large vessel vasculitis affecting young women of childbearing age. The outcome of pregnancies in TAK patients, factors associated with maternal and foetal complications and adverse outcomes were analysed.

Methods

All pregnancies in women with a TAK diagnosis were retrospectively included from 20 French hospitals providing care for TAK, until August 2015.

Results

The study consisted of 43 pregnancies in 33 women, including 29 with a pre-existing TAK diagnosis and 4 diagnosed during pregnancy. Complications were observed in 20 pregnancies (47%), including 35% with arterial hypertension (n = 15), 9% with pre-eclampsia (n = 4), 2% with HELLP syndrome (n = 1) and 14% with intrauterine growth restriction (IUGR, n = 6, leading in one case to a medically indicated termination of pregnancy). There were 42 live births (98%) at a median term of 38 [27–42] weeks gestation including 9 before 37 weeks (21%). The median birth weight was 2940 [610–4310] grams. Five children (12%) required transfer to a neonatal intensive care unit. One premature boy (27 weeks gestation) died after 2 days. Treatment during pregnancy included steroids (n = 25/43; 58%), azathioprine (n = 9/43; 21%) and infliximab (n = 1/43; 2%). The risk of developing arterial hypertension during pregnancy was associated with previous chronic arterial hypertension and with an infra-diaphragmatic vasculitis injury (P = 0.01 and P = 0.04, respectively). No correlation was reported between TAK activity and any of the obstetrical complications described in the study.

Conclusion

This study showed a high rate of adverse obstetrical complications without significant impact on live birth rates. Pregnancy did not appear to influence TAK disease activity.

Key Points

• We observed a high rate of adverse obstetrical complications in women with Takayasu arteritis; however, the rate of live births was high. Pregnancy did not appear to influence TA disease activity.

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References

  1. Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS (1994) Takayasu arteritis. Ann Intern Med 120(11):919–929

    Article  CAS  Google Scholar 

  2. Ishikawa K, Matsuura S (1982) Occlusive thromboaortopathy (Takayasu's disease) and pregnancy. Clinical course and management of 33 pregnancies and deliveries. Am J Cardiol 50(6):1293–1300

    Article  CAS  Google Scholar 

  3. Wong VC, Wang RY, Tse TF (1983) Pregnancy and Takayasu's arteritis. Am J Med 75(4):597–601

    Article  CAS  Google Scholar 

  4. Suri V, Aggarwal N, Keepanasseril A, Chopra S, Vijayvergiya R, Jain S (2010) Pregnancy and Takayasu arteritis: a single centre experience from North India. J Obstet Gynaecol Res 36(3):519–524

    Article  Google Scholar 

  5. Mandal D, Mandal S, Dattaray C et al (2012) Takayasu arteritis in pregnancy: an analysis from eastern India. Arch Gynecol Obstet 285(3):567–571

    Article  Google Scholar 

  6. Hidaka N, Yamanaka Y, Fujita Y, Fukushima K, Wake N (2012) Clinical manifestations of pregnancy in patients with Takayasu arteritis: experience from a single tertiary center. Arch Gynecol Obstet 285(2):377–385

    Article  Google Scholar 

  7. Tanaka H, Tanaka K, Kamiya C, Iwanaga N, Yoshimatsu J (2014) Analysis of pregnancies in women with Takayasu arteritis: complication of Takayasu arteritis involving obstetric or cardiovascular events. J Obstet Gynaecol Res 40(9):2031–2036

    Article  Google Scholar 

  8. de Jesus GR, d'Oliveira IC, dos Santos FC et al (2012) Pregnancy may aggravate arterial hypertension in women with Takayasu arteritis. Israel Med Assoc J 14(12):724–728

    Google Scholar 

  9. Aso T, Abe S, Yaguchi T (1992) Clinical gynecologic features of pregnancy in Takayasu arteritis. Heart Vessels Suppl 7:125–132

    Article  CAS  Google Scholar 

  10. Sharma BK, Jain S, Vasishta K (2000) Outcome of pregnancy in Takayasu arteritis. Int J Cardiol 75(Suppl 1):S159–S162

    Article  Google Scholar 

  11. Comarmond C, Mirault T, Biard L et al (2015) Takayasu Arteritis and Pregnancy. Arthritis Rheumatol (Hoboken, NJ) 67(12):3262–3269

    Article  CAS  Google Scholar 

  12. Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW Jr (1990) The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33(8):1129–1134

    Article  CAS  Google Scholar 

  13. Ishikawa K (1988) Diagnostic approach and proposed criteria for the clinical diagnosis of Takayasu's arteriopathy. J Am Coll Cardiol 12(4):964–972

    Article  CAS  Google Scholar 

  14. Sharma BK, Jain S, Suri S, Numano F (1996) Diagnostic criteria for Takayasu arteritis. Int J Cardiol 54(Suppl):S141–S147

    Article  Google Scholar 

  15. Hata A, Noda M, Moriwaki R, Numano F (1996) Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol 54(Suppl):S155–S163

    Article  Google Scholar 

  16. Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, Forest JC, Giguère Y (2010) Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol 116(2 Pt 1):402–414

    Article  Google Scholar 

  17. Weiss BM, Zemp L, Seifert B, Hess OM (1998) Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol 31(7):1650–1657

    Article  CAS  Google Scholar 

  18. Alpay-Kanitez N, Omma A, Erer B et al (2015) Favourable pregnancy outcome in Takayasu arteritis: a single-centre experience. Clin Exp Rheumatol 33(2 Suppl 89):S-7-10

    PubMed  Google Scholar 

  19. Mohammad AJ, Mandl T (2015) Takayasu arteritis in southern Sweden. J Rheumatol 42(5):853–858

    Article  Google Scholar 

  20. Assad AP, da Silva TF, Bonfa E, Pereira RM (2015) Maternal and neonatal outcomes in 89 patients with Takayasu arteritis (TA): comparison before and after the TA diagnosis. J Rheumatol 42(10):1861–1864

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Sorbonne Université, Département Hospitalo-Universitaire-Inflammation-Immunopathologie-Biothérapie (DMU i3), Service de Médecine Interne, F-75005, Paris, France

    Noémie Abisror, Arsene Mekinian, Constance Lahuna & Olivier Fain

  2. Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Hôpital Saint Antoine, AP-HP, 184 rue du Faubourg Saint Antoine, 75012, Paris, France

    Noémie Abisror, Arsene Mekinian & Olivier Fain

  3. Service de Médecine Interne-Centre de Référence des Maladies Autoimmunes et Systémiques Rares (GL, EH), CHRU, Lille, France

    Eric Hachulla & Marc Lambert

  4. Centre de référence maladies auto-immunes et systémiques rares d’île de France, Service de Médecine Interne Pôle médecine, Hôpital Cochin Université Paris Descartes-Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75679, cedex 14, Paris, France

    Nathalie Morel, Luc Mouthon, Patrice Cacoub & Julien Haroche

  5. Service de Médecine Interne, Centre de Référence National pour le Lupus Systémique et le Syndrome des Antiphospholipides, Université Paris 6, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France

    Catherine Chapelon

  6. Service de Médecine Interne, Hôpital Archet, Nice, France

    Nihal Martis & Jean Gabriel Fuzibet

  7. Service de Médecine Interne, Hôpital La Timone, Marseille, France

    Pauline Belenotti & Laure Swiader

  8. Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne, Hôpital Avicenne, Université Paris 13, 93000, Bobigny, France

    Robin Dhote, Loic Guillevin, Veronique Le Guern & Nathalie Costedoat-Chalumeau

  9. Clinique Universitaire de Médecine Interne, Pôle pluridisciplinaire de Médecine et de Gérontologie clinique, Grenoble University Hospital, CS, 10217, Grenoble, France

    Françoise Sarrot-Reynault

  10. Service de Médecine Interne, Clermont Ferrand, France

    Marc Andre

  11. Service de Médecine Interne, Amiens, France

    Smail Amar

  12. Service de Médecine Interne, Saint-Etienne, France

    Jean Baptiste Gauthier

  13. Service de Médecine Interne, Nantes, France

    Pascal Cathebras & Antoine Neel

  14. Internal Medicine Department, CHU Erasme, Université Libre de Bruxelles, Brussells, Belgium

    Frederic Vandergheynst

  15. Service de Médecine Interne, Strasbourg, France

    Murielle Rondeau

  16. Service de Médecine Interne, Hôpital Hauts-Clos, Troyes, France

    Alain Fur

  17. Service de médecine interne, maladies infectieuses, UCSA, Centre Hospitalier Régional Félix-Guyon, 97400, Saint-Denis, Réunion, France

    Fréderic Renou

  18. Service de Médecine Interne, Centre de référence des cytopénies auto-immunes de l’adulte, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université Paris Est Créteil, Créteil, France

    Bertrand Godeau

  19. Service de Médecine Interne, Coulommiers, France

    Bruno Devaux

  20. Service de Médecine Interne, Poissy, Saint Germain, France

    Catherine Veyssier-Belot

  21. Service de médecine interne, Hôpital Jean-Bernard, CHU, 86021, Poitiers, France

    Olivier Pourrat

  22. Service de Médecine Interne, HP Metz Site Belle Isle, Metz, France

    François Maurier

  23. INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France

    Nathalie Costedoat-Chalumeau

Authors
  1. Noémie Abisror
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  2. Arsene Mekinian
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  3. Eric Hachulla
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  4. Marc Lambert
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  5. Nathalie Morel
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  6. Catherine Chapelon
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  7. Nihal Martis
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  8. Jean Gabriel Fuzibet
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  9. Pauline Belenotti
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  10. Laure Swiader
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  11. Robin Dhote
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  12. Luc Mouthon
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  13. Françoise Sarrot-Reynault
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  14. Marc Andre
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  15. Smail Amar
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  16. Jean Baptiste Gauthier
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  17. Pascal Cathebras
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  18. Antoine Neel
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  19. Frederic Vandergheynst
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  20. Murielle Rondeau
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  21. Alain Fur
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  22. Fréderic Renou
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  23. Bertrand Godeau
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  24. Bruno Devaux
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  25. Catherine Veyssier-Belot
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  26. Patrice Cacoub
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  27. Olivier Pourrat
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  28. Julien Haroche
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  29. François Maurier
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  30. Constance Lahuna
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  31. Olivier Fain
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  32. Loic Guillevin
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  33. Veronique Le Guern
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  34. Nathalie Costedoat-Chalumeau
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Correspondence to Arsene Mekinian.

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Abisror, N., Mekinian, A., Hachulla, E. et al. Analysis of risk factors for complications and adverse obstetrical outcomes in women with Takayasu arteritis: a French retrospective study and literature review. Clin Rheumatol 39, 2707–2713 (2020). https://doi.org/10.1007/s10067-020-05024-4

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  • DOI: https://doi.org/10.1007/s10067-020-05024-4

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