AAV Requires Preconception Counseling, Close Monitoring During Pregnancy

Adverse pregnancy outcomes appear more common among women with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis than the general public, according to meta-analysis results published online ahead of print in Joint Bone Spine.

“These findings underline the importance of preconception counseling and the necessity of close monitoring in these patients, similarly to other systemic inflammatory diseases,” wrote corresponding author Styliani Partalidou, MD, of Aristotle University of Thessaloniki in Greece, and study coauthors.

The systematic review and meta-analysis spanned six studies that included 92 pregnancies in women with ANCA-associated vasculitis. Researchers investigated the rate of three outcomes: preterm delivery, neonates with intrauterine growth restriction, and ANCA-associated vasculitis disease flare.

Meta-analysis revealed an 18% prevalence of preterm delivery and a 20% prevalence of neonates with intrauterine growth restriction, according to the study. The prevalence of preterm delivery in the general population in Europe is between 5% and 9%, researchers noted, while the prevalence of neonates with intrauterine growth restriction is 5%.

The prevalence of disease flare during pregnancy for women with ANCA-associated vasculitis was 28%, the study found.

“However, the flares are mostly mild, with no harmful effects on the newborns,” researchers wrote. “These findings indicate that pregnancy in this population can be successful, mainly when conception is achieved during remission.”

—Jolynn Tumolo

Reference

Partalidou S, Mamopoulos A, Dimopoulou D, Sarafidis P, Dimitroulas T. Pregnancy outcomes in ANCA-associated vasculitis patients: A systematic review and meta-analysis. Joint Bone Spine. Published online July 5, 2023. doi:10.1016/j.jbspin.2023.105609