title: Takayasu Arteritis and Pregnancy.
abstract: OBJECTIVE
  To assess the relationship between Takayasu arteritis (TAK) and pregnancy outcome.
  
  
  METHODS
  This study included 240 pregnancies in 96 patients fulfilling the American College of Rheumatology 1990 criteria for the classification of TAK and/or the 1994 Chapel Hill Consensus Conference nomenclature/criteria for vasculitis. We analyzed obstetric and maternal outcomes in women who were pregnant before and/or at the same time as or after TAK diagnosis. We assessed factors associated with complicated pregnancy.
  
  
  RESULTS
  One hundred forty-two pregnancies occurred in 52 patients before TAK diagnosis (median age at pregnancy 26 years [interquartile range 23-30 years]), and 98 pregnancies occurred in 52 patients concomitant with or after TAK diagnosis (median age at pregnancy 28 years [interquartile range 26-31 years]). Pregnancies concomitant with or after TAK diagnosis had a 13-fold higher rate of obstetric complications compared to pregnancies before TAK diagnosis (odds ratio 13 [95% confidence interval 5-33], P < 0.0001). TAK was associated with a 40% frequency of obstetric complications, including preeclampsia/eclampsia (24 pregnancies [24%]), premature delivery (8 pregnancies [8%]), and intrauterine fetal growth restriction or death (5 pregnancies [5%]). Maternal complications of TAK occurred during 39% of pregnancies and included mainly new-onset or worsening hypertension (26 pregnancies [27%]). In multivariate analysis, smoking (odds ratio 6.15 [95% confidence interval 1.31-28.8]) and disease activity of TAK (a National Institutes of Health score of >1) (odds ratio 28.7 [95% confidence interval 7.89-104.7]) were independently associated with obstetric and maternal complications.
  
  
  CONCLUSIONS
  TAK negatively affects pregnancy outcomes. Disease activity increases the risk of obstetric and maternal complications, mainly due to arterial hypertension.
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: C
authors: C
authors: Comarmond
authors: AP-HP, Hôpital Européen Georges-Pompidou, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux Universitaires Paris Ouest, and Université Paris Descartes, Paris 5, Sorbonne Paris Cité, Paris, France.
authors: T
authors: T
authors: Mirault
authors: AP-HP, SBIM, Hôpital Saint-Louis and Université Paris Diderot, Paris 7, INSERM, CRESS UMR-S 1153, Paris, France.
authors: L
authors: L
authors: Biard
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Sorbonne Universités, Université Pierre et Marie Curie, Paris 6, CNRS UMR 7222, INSERM U1150, Paris, France.
authors: J
authors: J
authors: Nizard
authors: Hôpital Claude Huriez, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre Hospitalier Régional Universitaire de Lille, and Université de Lille 2, Lille, France.
authors: M
authors: M
authors: Lambert
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: B
authors: B
authors: Wechsler
authors: Hôpital Claude Huriez, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre Hospitalier Régional Universitaire de Lille, and Université de Lille 2, Lille, France.
authors: E
authors: E
authors: Hachulla
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: L
authors: L
authors: Chiche
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: F
authors: F
authors: Koskas
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: J
authors: J
authors: Gaudric
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière and Université Pierre et Marie Curie, Paris 6, INSERM-CNRS-LIB, Paris, France.
authors: P
authors: P
authors: Cluzel
authors: AP-HP, Hôpital Européen Georges-Pompidou, INSERM UMR970, PARCC, Centre de Référence des Maladies Vasculaires Rares, Hôpitaux Universitaires Paris Ouest, and Université Paris Descartes, Paris 5, Sorbonne Paris Cité, Paris, France.
authors: E
authors: E
authors: Messas
authors: AP-HP, SBIM, Hôpital Saint-Louis and Université Paris Diderot, Paris 7, INSERM, CRESS UMR-S 1153, Paris, France.
authors: M
authors: M
authors: Resche-Rigon
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: J C
authors: JC
authors: Piette
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: P
authors: P
authors: Cacoub
authors: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Référence des Maladies Auto-Immunes et Systémiques Rares, and Université Pierre et Marie Curie, Paris 6, Paris, France.
authors: D
authors: D
authors: Saadoun
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D015999:Multivariate Analysis; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D013625:Takayasu Arteritis / Q000453:epidemiology*; D020246:Venous Thrombosis / Q000453:epidemiology; D055815:Young Adult