Mort fœtale in utero durant la gestation compliquant une maladie de Takayasu : à propos d’un cas et revue de la littérature

Maternal and Neonatal Outcomes in 89 Patients with Takayasu Arteritis (TA): Comparison Before and After the TA Diagnosis

Objective.

To evaluate maternal and neonatal outcomes in patients before and after a diagnosis of Takayasu arteritis (TA).

Methods.

Patients diagnosed with TA according to the American College of Rheumatology criteria were selected from the Vasculitis Outpatient Clinic of the Rheumatology Division. Healthy female staff members of this hospital of similar age and educational level were selected as the controls. The disease data were obtained from an ongoing electronic database protocol. A standardized questionnaire, emphasizing gestational history, was applied to both groups. The prevalence of fetomaternal complications and disease variables were evaluated between the groups and a statistical analysis was performed.

Results.

A total of 89 patients with TA (156 pregnancies) and 89 healthy controls (181 pregnancies) were evaluated. There were 75.6% pregnancies that occurred before the TA diagnosis (pre-TA group) and 24.3% after (post-TA group). In the pre-TA group, higher rates of hypertension (HTN; 27.1% vs 3.9%, p < 0.001), low birth weight (16.8% vs 6.5%, p = 0.012), and perinatal mortality (7.9% vs 0.7%, p = 0.003) were observed compared with healthy controls. The frequency of abortions and the average number of children were similar in both groups (p > 0.05). Further comparison of the pre- and post-TA groups revealed similar rates of HTN, abortion, and low birth weight, and higher rates of Cesarean delivery (p = 0.002), prematurity (p < 0.001), and infection (p = 0.045) in the latter group.

Conclusion.

Our study identified that patients with TA, even before the disease diagnosis, have a worse fetal outcome that is most likely associated with high rates of HTN. TA was identified as an additional differential diagnosis for HTN in pregnancy.