C.A. Sims, MD, Durham Veterans Affairs Healthcare System, Division of Rheumatology & Immunology, Duke University, Durham, North Carolina;
A.M. Eudy, PhD, Department of Medicine, Duke University, Durham, North Carolina.
J Rheumatol. 2024 Oct 1;51(10):1003-1008. doi: 10.3899/jrheum.2023-1246.
There are limited data on the reproductive health of women with vasculitis. This study used a prospective, international vasculitis pregnancy registry to survey women during and after pregnancy.
The Vasculitis Pregnancy Registry (VPREG) is imbedded within the Vasculitis Patient-Powered Research Network, an international online research infrastructure. Any pregnant woman with a diagnosis of vasculitis can self-enroll. After enrollment, women are invited to complete online surveys at study entry, once per trimester, and postpartum. Descriptive statistics are reported here.
Between 2015 and 2022, 147 women with 149 pregnancies enrolled in VPREG from 16 countries. Data on 78 pregnancies with known outcomes were included in this analysis. During pregnancy, women on average experienced low levels of pain related to vasculitis (scale 0-10, median 2 [IQR 1-5]) and preserved feelings of wellness (scale 0-10, median 3 [IQR 1-5]). Thirty-six percent of women reported their vasculitis was active during pregnancy. Of the 14 women requiring hospitalization during pregnancy outside of delivery, 4 cited active vasculitis as the indication. Most women (54/73, 74%) were prescribed medications for vasculitis during pregnancy. Seventy-six (97%) pregnancies resulted in live births, with 64% delivering vaginally and 21% experiencing a preterm delivery.
These results demonstrate that most women with vasculitis can experience pregnancies that result in live births delivered at term. During pregnancy, a minority of women reported flares of vasculitis or the need for hospitalization due to vasculitis. These data are useful to rheumatologists and patients to inform and facilitate discussions about reproductive health and vasculitis.
关于血管炎患者生殖健康的数据有限。本研究使用前瞻性国际血管炎妊娠登记处对妊娠期间和妊娠后的女性进行了调查。
血管炎妊娠登记处(VPREG)嵌入在血管炎患者驱动的研究网络中,这是一个国际在线研究基础设施。任何患有血管炎的孕妇都可以自行登记。登记后,女性在研究入组时、每三个月一次和产后被邀请完成在线调查。此处报告描述性统计数据。
2015 年至 2022 年,来自 16 个国家的 147 名患有血管炎的女性通过 VPREG 登记了 149 次妊娠。这项分析包括了 78 次已知结局的妊娠数据。在怀孕期间,女性平均经历了低水平的与血管炎相关的疼痛(0-10 分,中位数 2 [IQR 1-5]),并且保持了良好的感觉(0-10 分,中位数 3 [IQR 1-5])。36%的女性报告在怀孕期间血管炎活跃。在怀孕期间因血管炎以外的原因需要住院的 14 名女性中,有 4 名女性表示血管炎活跃是住院的原因。大多数女性(73 名中的 54 名,74%)在怀孕期间接受了血管炎治疗药物。76 次(97%)妊娠导致活产,64%经阴道分娩,21%早产。
这些结果表明,大多数患有血管炎的女性可以经历导致足月分娩的妊娠。在怀孕期间,少数女性报告血管炎发作或因血管炎需要住院治疗。这些数据对风湿病学家和患者都很有用,可以为生殖健康和血管炎的讨论提供信息和便利。