Pregnancy and childbirth in Takayasu arteritis in Japan: A nationwide retrospective study-Reference-Cited by-同舟云学术

Pregnancy and childbirth in Takayasu arteritis in Japan: A nationwide retrospective study

Published:2024-08-08 Issue: Volume: Page:
ISSN:1439-7595
Container-title:Modern Rheumatology
language:en
Short-container-title:

Author:

Miyamae Takako¹²^ORCID,Manabe Yusuke³⁴,Sugihara Takahiko⁵⁶,Umezawa Natsuka⁵,Yoshifuji Hajime⁷,Tamura Naoto⁸,Abe Yoshiyuki⁸,Furuta Shunsuke⁹,Nagafuchi Hiroko¹⁰,Ishizaki Jun¹¹,Nakano Naoko¹²,Atsumi Tatsuya¹³,Karino Kohei¹³,Amano Koichi¹⁴,Kurasawa Takahiko¹⁴,Ito Shuichi¹⁵,Yoshimi Ryusuke¹⁶,Ogawa Noriyoshi¹⁷,Banno Shogo¹⁸,Naniwa Taio¹⁹²⁰,Ito Satoshi²¹,Hara Akinori²²,Hirahara Shinya²²³,Uchida Haruhito A²⁴,Onishi Yasuhiro²⁵,Murakawa Yohko²⁶,Komagata Yoshinori²⁷,Nakaoka Yoshikazu³,Harigai Masayoshi²²³

Affiliation:

1. Department of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical University Hospital , Tokyo, Japan

2. Division of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine , Tokyo, Japan

3. Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute , Suita, Japan

4. Department of Clinical Immunology, Japan Community Health Care Organization Osaka Hospital , Osaka, Japan

5. Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan

6. Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine , Tokyo, Japan

7. Department of Rheumatology and Clinical Immunology, Kyoto University, Graduate School of Medicine , Kyoto, Japan

8. Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine , Tokyo, Japan

9. Department of Allergy and Clinical Immunology, Chiba University Hospital , Chiba, Japan

10. Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine , Kawasaki, Japan

11. Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine , Toon, Ehime, Japan

12. Pediatric Medical Center, Ehime Prefectural Central Hospital , Matsuyama, Japan

13. Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo, Japan

14. Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University , Kawagoe, Japan

15. Department of Pediatrics, Yokohama City University School of Medicine , Yokohama, Japan

16. Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine , Yokohama, Japan

17. Department of Internal Medicine 3, Division of Immunology and Rheumatology, Hamamatsu University School of Medicine , Hamamatsu, Japan

18. Department of Rheumatology and Nephrology, Aichi Medical University School of Medicine , Nagakute, Japan

19. Division of Rheumatology, Department of Internal Medicine, Nagoya City University Hospital , Nagoya, Japan

20. Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences , Nagoya, Japan

21. Department of Rheumatology, Niigata Rheumatic Center , Shibata, Japan

22. Department of Hygiene and Public Health, Kanazawa University , Kanazawa, Japan

23. Department of Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical University Hospital , Tokyo, Japan

24. Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences , Okayama, Japan

25. Department of Comprehensive Therapy for Chronic Kidney Disease, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences , Okayama, Japan

26. Department of Rheumatology, Shimane University Faculty of Medicine , Izumo, Japan

27. Department of Nephrology and Rheumatology, Kyorin University School of Medicine , Tokyo, Japan

Abstract

ABSTRACT Objectives This study aimed to understand the status quo of medical treatments and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children’s birth outcomes. Methods This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis. Results This study enrolled 51 cases and 68 pregnancies during 2019–21. Of these, 48 cases and 65 pregnancies resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31 years, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. TAK relapsed in four (6.2%) and eight (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low-birth-weight infants were observed, and none had serious postnatal abnormalities. Conclusions Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in <20% of pregnancies.

Publisher

Oxford University Press (OUP)

Link

https://academic.oup.com/mr/advance-article-pdf/doi/10.1093/mr/roae068/58869350/roae068.pdf

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