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Maternal–fetal outcomes and therapeutic strategies in pregnancies complicated by Takayasu arteritis: a comprehensive analysis
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Maternal–fetal outcomes and therapeutic strategies in pregnancies complicated by Takayasu arteritis: a comprehensive analysis
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Journal Article
Maternal–fetal outcomes and therapeutic strategies in pregnancies complicated by Takayasu arteritis: a comprehensive analysis
2025
Overview
Objective
To evaluate maternal–fetal outcomes and therapeutic efficacy in Takayasu arteritis (TA)-complicated pregnancies through integrated retrospective analysis and meta-analytic synthesis.
Methods
A 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.
Results
Among 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).
Conclusion
TA 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.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Antihypertensive Agents - therapeutic use
/ Female
/ Glucocorticoids - therapeutic use
/ Humans
/ Immunosuppressive Agents - therapeutic use
/ Ischemia
/ Medicine
/ Patients
/ Pregnancy Complications, Cardiovascular - drug therapy
/ Pregnancy Outcome - epidemiology
/ Premature Birth - epidemiology
/ Steroids
/ Takayasu Arteritis - complications
