Why the study?
To evaluate maternal-fetal outcomes and therapeutic efficacy in Takayasu arteritis-complicated pregnancies.
Do therapeutic strategies and the timing of Takayasu arteritis diagnosis impact maternal-fetal outcomes in complicated pregnancies?
Do therapeutic strategies and the timing of Takayasu arteritis diagnosis impact maternal-fetal outcomes in complicated pregnancies?
Takayasu arteritis significantly increases the risk of adverse maternal-fetal outcomes, particularly when pregnancy occurs before TA diagnosis, highlighting the need for multidisciplinary management and postpartum thromboprophylaxis.
Answers are grounded in this paper and cite their sources.
Highlights persistent maternal-fetal risks in TA pregnancies; leaves open optimal phase-specific strategies pending prospective trials.
OBJECTIVE: To evaluate maternal-fetal outcomes and therapeutic efficacy in Takayasu arteritis (TA)-complicated pregnancies through integrated retrospective analysis and meta-analytic synthesis. METHODS: A dual-design study was conducted: (1) retrospective analysis of 20 pregnancies (17 patients) at West China Second Hospital (2012-2024), stratifying TA phases (acute/prolonged/stable); (2) systematic review with random-effects meta-analysis of 16 studies (568 pregnancies globally). Clinical data encompassed maternal-fetal profiles, TA-specific variables, laboratory metrics (hematologic/coagulation parameters), and therapies (glucocorticoids /immunosuppressants /antihypertensives). Outcomes were compared against normative standards using t-tests, Wilcoxon, chi-square, and meta-regression. RESULTS: Among 20 pregnancies (median maternal age 28.5 years), 50% had at least one obstetric complication, with arterial stenosis (80%) and hypertension (40%) predominant. Meta-analysis revealed 42.6% adverse outcomes: gestational hypertension (26.1%), fetal growth restriction (17.7%), and preterm delivery (13.6%). Hematological analysis (n = 20) showed elevated WBC, PCT, TT, fibrinogen, urinary protein, and ALT (all P < 0.05), alongside reduced PT, albumin, and bilirubin (P < 0.05). Regarding the analysis results of inflammatory indicators, CRP (prepartum) (95%CI = 0.969-1.034, OR = 1.001), CRP (postpartum) (95%CI = 0.920-1.217, OR = 1.058), and ESR (95%CI = 0.952-1.101, OR = 1.024) showed no statistically significant association with pregnancy outcomes. Neither pre-pregnancy nor gestational glucocorticoids (prednisone vs methylprednisolone) or immunosuppressants significantly reduced complications (all RR 95% CI crossed 1; P > 0.05). Antihypertensive therapy showed no correlation with preeclampsia (P > 0.05). CONCLUSION: TA significantly elevates maternal-fetal risks, driving hypertension, growth restriction, and preterm birth via vasculopathic-inflammatory pathways. Postpartum hypercoagulability (↑fibrinogen, ↓prothrombin time) necessitates multidisciplinary coagulation monitoring and mandatory thromboprophylaxis.
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Chen et al. (2025) studied this question.
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