Takayasu's Arteritis (TAK) is a rare vasculitis of the large blood vessels, which predominately affects women of childbearing age. Two posters (abstract #3070, 3071) described pregnancy outcomes in patients with TAK. Both studies were from France.
The first study included 41 pregnancies after TAK diagnosis in 31 patients, and the second included 142 pregnancies before the diagnosis of TAK and 98 after TAK diagnosis in 52 patients. The mean age at pregnancy after TAK diagnosis was 30 and disease duration was ~5 years. The majority of patients were treated with corticosteroids and antiplatelet agents throughout pregnancy, and a quarter were on additional immunosuppressants.
Maternal obstetrical complications were common in both studies, particularly new or worsening hypertension (>25% with 7% having preeclampsia). Fetal complications included premature birth (10-20%), intrauterine growth restriction (5%), and neonatal fatality (2%).
A substantial proportion of patients had a TAK disease flare during pregnancy (20%) and this was significantly associated with obstetrical complications. Active disease within the 6 months prior to pregnancy significantly increased the risk of flare during pregnancy. Other predictors for poor obstetrical outcomes included smoking and more diffuse vessel involvement.
These studies remind us that it is imperative that disease is under good control in order to ensure the best possible pregnancy outcomes in TAK patients.