Abstract: FR-PO861
Maternal and Foetal Outcomes in ANCA Vasculitis: A Review of the Literature
Session Information
- Women's Health and Kidney Diseases
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2200 Women's Health and Kidney Diseases
Authors
- Williamson, Tilly, The University of Manchester, Manchester, United Kingdom
- Floyd, Lauren, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Leung, Wing Yin, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Moore, Louise Rachel, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Dhaygude, Ajay Prabhakar, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Morris, Adam, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
Background
Limited data exists on the effects of ANCA-associated vasculitis (AAV) on maternal and foetal outcomes. Although historically rare in pregnancy and primarily affecting individuals >65 yrs, the incidence of AAV in younger women is increasing. This highlights the significant impact of AAV on fertility and the need for increased healthcare provision and interdisciplinary approach to management. There is however a lack of literature guiding healthcare professionals in managing AAV patients throughout the pre-conception, prenatal and postnatal periods. This review examines maternal and foetal outcomes associated with AAV, compares outcomes with the general population and explores the effectiveness of AAV treatments during pregnancy.
Methods
A literature search using PubMed, Cochrane and WoS was conducted, to identify all published studies that included pregnant women with a diagnosis of AAV. Two reviewers screened the papers and studies were assessed for quality.
Results
Five papers were included with a total of 60 women and 84 pregnancies. Results showed an increased risk of pre-eclampsia, pre-term delivery, low birth weight and high rates of caesarean delivery compared to the general population (Fig.1). Risks varied according to organ involvement with patients who had multi-system involvement at highest risk of adverse outcomes. The majority of patients received prednisolone and or azathioprine treatment during their pregnancy and >30% received no treatment at all. Pregnancies in women with disease remission had favourable outcomes.
Conclusion
Data on pregnancy outcomes in AAV is limited and there is a lack of guidance regarding patient management in the pre-conception, prenatal and postnatal periods. The literature suggests adverse outcomes in pregnant patients with AAV, emphasizing the need for additional support and further research looking at maternal health risks, the impact of disease relapse and the role of data registries.
Maternal and foetal outcomes in AAV compared to the health population averages