title: Systemic vasculitis and pregnancy: a multicenter study on maternal and neonatal outcome of 65 prospectively followed pregnancies.
abstract: OBJECTIVE
  Systemic vasculitis (SV) are uncommon diseases that rarely affect women during their reproductive age; little data, mainly retrospective, is available on this topic. The aim of our study was to evaluate maternal/neonatal outcome and disease course before, during and after pregnancy.
  
  
  METHODS
  Sixty-five pregnancies in 50 women with SV were followed by a multispecialistic team in 8 institutions between 1995 and 2014. Clinical data on pregnancy, 1year before and 1year after delivery was retrospectively collected. The rate of pregnancy complications was compared to that of a General Obstetric Population (GOP) of 3939 women.
  
  
  RESULTS
  In 2 patients the diagnosis of SV was done during pregnancy; 59 out of the remaining 63 started when maternal disease was quiescent. We recorded 56 deliveries with 59 live births, 8 miscarriages and 1 fetal death. In SV, preterm, particularly early preterm (<34weeks) deliveries and cesarean sections appeared significantly more frequent than in GOP (11.3% vs 5.0%, p=0.049 and 48.2% vs 31.0%, p=0.009). Vasculitis-related complications occurred in 23 pregnancies (35.4%), with 5 severe events (7.7%) including 3 cases of transient ischemic attack (TIA). Data about the post-partum period were available for 56 pregnancies: 12 flares (21.4%) occurred, with 1 severe event (1.8%).
  
  
  CONCLUSIONS
  SV patients can have successful pregnancies (especially during a disease remission phase) despite an increased rate of preterm delivery. Severe flares were limited, but the occurrence of 3 TIA suggests that particular attention should be given to possible thrombotic complications in SV patients during pregnancy and puerperium.
authors: Spedali Civili,University of Brescia, Brescia, Italy.
authors: Micaela
authors: M
authors: Fredi
authors: Spedali Civili,University of Brescia, Brescia, Italy.
authors: Maria Grazia
authors: MG
authors: Lazzaroni
authors: University of Pisa, Pisa, Italy.
authors: Chiara
authors: C
authors: Tani
authors: University of Pavia, IRCCS Policlinico S.Matteo, Pavia, Italy.
authors: Véronique
authors: V
authors: Ramoni
authors: University of Milano, Istituto Ortopedico Gaetano Pini, Milan, Italy.
authors: Maria
authors: M
authors: Gerosa
authors: University of Pavia, IRCCS Policlinico S.Matteo, Pavia, Italy.
authors: Flora
authors: F
authors: Inverardi
authors: University of Padova, Padova, Italy.
authors: Paolo
authors: P
authors: Sfriso
authors: Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors: Paola
authors: P
authors: Caramaschi
authors: Spedali Civili,University of Brescia, Brescia, Italy.
authors: Laura
authors: L
authors: Andreoli
authors: Ospedale San Carlo Borromeo, Milano, Italy.
authors: Renato Alberto
authors: RA
authors: Sinico
authors: Spedali Civili,University of Brescia, Brescia, Italy.
authors: Mario
authors: M
authors: Motta
authors: Spedali Civili,University of Brescia, Brescia, Italy.
authors: Andrea
authors: A
authors: Lojacono
authors: Clinica Ostetrica L.Mangiagalli, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors: Laura
authors: L
authors: Trespidi
authors: University of Pisa, Pisa, Italy.
authors: Francesca
authors: F
authors: Strigini
authors: Ospedale Papa Giovanni XXIII, Bergamo, Italy.
authors: Antonio
authors: A
authors: Brucato
authors: University of Pavia, IRCCS Policlinico S.Matteo, Pavia, Italy.
authors: Roberto
authors: R
authors: Caporali
authors: University of Padova, Padova, Italy.
authors: Andrea
authors: A
authors: Doria
authors: University Paris Descartes, National Referral Center for Necrotizing Vasculitides and Systemic Sclerosis, Hôpital Cochin, Paris, France.
authors: Loic
authors: L
authors: Guillevin
authors: University of Milano, Istituto Ortopedico Gaetano Pini, Milan, Italy.
authors: Pier Luigi
authors: PL
authors: Meroni
authors: University of Pavia, IRCCS Policlinico S.Matteo, Pavia, Italy.
authors: Carlomaurizio
authors: C
authors: Montecucco
authors: University of Pisa, Pisa, Italy.
authors: Marta
authors: M
authors: Mosca
authors: Spedali Civili,University of Brescia, Brescia, Italy. Electronic address: angela.tincani@unibs.it.
authors: Angela
authors: A
authors: Tincani
mesh_terms: D000022:Abortion, Spontaneous; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death; D006801:Humans; D015337:Multicenter Studies as Topic; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D056647:Systemic Vasculitis / Q000150:complications*
keywords: Pregnancy; Systemic vasculitis