title: Pregnancy outcome in patients with systemic vasculitis: a single-centre matched case-control study.
abstract: OBJECTIVE
  To study the outcome of pregnancy in patients with systemic vasculitis (SV) compared with age-, BMI- and ethnicity-matched healthy pregnant controls.
  
  
  METHODS
  Fifty-one pregnancies in 29 SV patients were retrospectively studied. There were nine patients with granulomatosis with polyangiitis (GPA), three with eosinophilic GPA, seven with Takayasu's arteritis, two with ANCA-positive vasculitis with renal involvement, two with Behçet's disease, three with urticarial vasculitis, one with primary cerebral vasculitis, one with relapsing polychondritis and one with IgA vasculitis. BVAS and the vasculitis damage index were evaluated retrospectively. Sixty-two healthy women with 156 pregnancies matched in a 2:1 ratio for age, BMI and ethnicity formed the control group.
  
  
  RESULTS
  Median gestational age at delivery was lower in the SV group: 36 weeks and 2 days (34-42) vs controls 40 (37-42) weeks (P < 0.03). Median birth weight in the SV group was 3.0 kg (2.0-5.2), whereas that of the controls was 3.5 (2.28-4.32) kg (P = 0.004). The median customized birth weight centile was 38.6 in the SV group and 37.2 in the control group. In the SV group, 9 patients had 13 miscarriages, 3 had pre-eclampsia, and 2 had an intrauterine death. In the control group, 20 patients had 27 miscarriages, 1 had pre-eclamptic toxaemia, and 1 had an antepartum haemorrhage. Eight patients with SV flared during pregnancy and 11 flared after delivery.
  
  
  CONCLUSIONS
  Patients with SV had a lower median gestational age, but customized birth weights were similar to those of healthy women. Women with SV may flare during pregnancy and the post-partum period and may experience significant pregnancy morbidity.
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Shirish R
authors.initials: SR
authors.lastname: Sangle
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Periklis
authors.initials: P
authors.lastname: Vounotrypidis
authors.affiliation: Women's Academic Health Centre, St Thomas' Hospital, Kings College London, Guys and St Thomas' NHS Foundation Trust and.
authors.forename: Annette
authors.initials: A
authors.lastname: Briley
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Louise
authors.initials: L
authors.lastname: Nel
authors.affiliation: Peter Gorer Department of Immunobiology, King's College London School of Medicine, Guy's Hospital, London, UK.
authors.forename: Pamela M K
authors.initials: PM
authors.lastname: Lutalo
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Simon
authors.initials: S
authors.lastname: Sanchez-Fernandez
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Ahlem
authors.initials: A
authors.lastname: Chaib
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Veronica
authors.initials: V
authors.lastname: Salas-Manzanedo
authors.affiliation: Women's Academic Health Centre, St Thomas' Hospital, Kings College London, Guys and St Thomas' NHS Foundation Trust and.
authors.forename: Andrew
authors.initials: A
authors.lastname: Shennan
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital.
authors.forename: Munther A
authors.initials: MA
authors.lastname: Khamashta
authors.affiliation: The Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, david.d'cruz@kcl.ac.uk.
authors.forename: David P
authors.initials: DP
authors.lastname: D'Cruz
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D056647:Systemic Vasculitis / Q000150:complications*
keywords: Birmingham vasculitis activity index; pregnancy outcome; systemic vasculitis; vasculitis damage index