Vasculitides flare associated with hypertensive disorders and other Pregnancy Risks among women

In a comprehensive nationwide cohort study spanning 2013 to 2018, Camille Mettler and team looked into the pregnancy risks faced by women with Systemic Vasculitides (SV), shedding light on potential complications and identifying associated risk factors. The outcomes were published in Arthritis & Rheumatology.

Systemic vasculitides, typically impacting individuals over 50, have been found to affect pregnant women, presenting challenges such as hypertensive disorders and preterm birth (PTB). The study was conducted using the French health insurance data warehouse and meticulously examined 3,155,723 pregnancies, including 646 pregnancies in women with SV, matched against 3,230 controls.

The findings revealed that SV significantly increased the risk of hypertensive disorders (OR 1.7, 95% CI [1.3-2.2]) and PTB (OR 1.8, 95% CI [1.4-2.3]). Notably, chronic renal failure before pregnancy, a history of or treated arterial hypertension, the occurrence of vasculitides flare during pregnancy, and specific SV subgroups independently contributed to the risk of hypertensive disorders.

For PTB, factors such as maternal age at delivery, chronic renal failure before conception, and the occurrence of vasculitides flare during pregnancy were identified as independent risk factors.

The study underscores that approximately one in seven pregnancies among women with SV is associated with hypertensive disorders or preterm birth, with the occurrence of vasculitides flare further intensifying these complications. This highlights the critical need for pre-pregnancy counseling to ensure disease stability and manage potential risks.

As the medical community gains deeper insights into the intersection of systemic vasculitides and pregnancy, this study serves as a crucial resource for healthcare practitioners, emphasizing the importance of tailored care for pregnant women with SV. Further research is warranted to refine strategies for mitigating risks and optimizing maternal and fetal health outcomes.

Reference:

Mettler, C., Beeker, N., Collier, M., Le Guern, V., Terrier, B., & Chouchana, L. (2023). Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women with Systemic Vasculitides: a nationwide population‐based cohort study. In Arthritis & Rheumatology. Wiley. https://doi.org/10.1002/art.42747