SynthesisArthritis research & therapy2025
Maternal-fetal outcomes and therapeutic strategies in pregnancies complicated by Takayasu arteritis: a comprehensive analysis.
Synthesis in Arthritis research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate maternal-fetal outcomes and therapeutic efficacy in Takayasu arteritis (TA)-complicated pregnancies through integrated retrospective analysis and meta-analytic synthesis.
methodsA dual-design study was conducted: (1) retrospective analysis of 20 pregnancies (17 patients) at West China Second Hospital (2012-2024), stratifying TA phases (acute/prolonged/stable); (2) systematic review with random-effects meta-analysis of 16 studies (568 pregnancies globally). Clinical data encompassed maternal-fetal profiles, TA-specific variables, laboratory metrics (hematologic/coagulation parameters), and therapies (glucocorticoids /immunosuppressants /antihypertensives). Outcomes were compared against normative standards using t-tests, Wilcoxon, chi-square, and meta-regression.
resultsAmong 20 pregnancies (median maternal age 28.5 years), 50% had at least one obstetric complication, with arterial stenosis (80%) and hypertension (40%) predominant. Meta-analysis revealed 42.6% adverse outcomes: gestational hypertension (26.1%), fetal growth restriction (17.7%), and preterm delivery (13.6%). Hematological analysis (n = 20) showed elevated WBC, PCT, TT, fibrinogen, urinary protein, and ALT (all P < 0.05), alongside reduced PT, albumin, and bilirubin (P < 0.05). Regarding the analysis results of inflammatory indicators, CRP (prepartum) (95%CI = 0.969-1.034, OR = 1.001), CRP (postpartum) (95%CI = 0.920-1.217, OR = 1.058), and ESR (95%CI = 0.952-1.101, OR = 1.024) showed no statistically significant association with pregnancy outcomes. Neither pre-pregnancy nor gestational glucocorticoids (prednisone vs methylprednisolone) or immunosuppressants significantly reduced complications (all RR 95% CI crossed 1; P > 0.05). Antihypertensive therapy showed no correlation with preeclampsia (P > 0.05).
conclusionTA significantly elevates maternal-fetal risks, driving hypertension, growth restriction, and preterm birth via vasculopathic-inflammatory pathways. Postpartum hypercoagulability (↑fibrinogen, ↓prothrombin time) necessitates multidisciplinary coagulation monitoring and mandatory thromboprophylaxis.
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