POS0813 FERTILITY AND PREGNANCY OUTCOMES IN TAKAYASU’S ARTERITIS
Authors: A. Taghiyeva, L. Kiliç, M. Cagan, E. C. Bolek, G. K. Yardimci, O. Karadag, O. Ozyuncu, Ş. A. Bilgen
Journal: Annals of the Rheumatic Diseases (2021)

Background: Takayasu’s arteritis (TA) is commonly seen in women of childbearing ages; therefore, reproductive health of TA patients is an important issue. Objectives: We aimed to evaluate the fertility and pregnancy (PG) outcomes of TA patients before and after diagnosis. Methods: In the prospective database of the Hacettepe University Vasculitis Research Centre (HUVAC), 202 TA patients (female =184) meeting the 1990 ACR criteria were registered by the end of February 2020. 120 patients who could be reached out gynaecological records and marriage status, were included in the study. We identified 233 PG in 82 of included these 120 TA patients (Figure 1). Demographic and clinical features, comorbidities, distribution of vascular involvement, obstetrical histories and outcomes were retrospectively evaluated. Patients were classified according to a novel proposed disease clusters (C1: Abdominal Predominant, C2: Aortic Arch Predominant, C3: Focal Disease) using the defined decision tree. Results: 12 of 96 (12.5%) married TA patients had infertility being defined as not being able to get pregnant after one year (or longer) of unprotected sex. 20 (16.7%) women had menopause before the age of 45, being defined as early menopause (EM). Compared to normal population, infertility (12.5% vs. 8.1%) and EM ratios (16.7% vs. 7.6%) seem to be increased in TA patients. (1, 2) 200 PG had occurred before TA diagnosis (bTA) in 71 women, and 33 PG were observed after TA diagnosis (aTA) diagnosis in 19 women (two patients diagnosed during PG). According to novel disease subsets, aTA patients classified into C1 (n=3; 15.7%), C2 (n=9; 47.3%) and C3 (n=6; 31.5%). One patient could not be classified. GHT was seen in 4 (12.1%) patients being the most frequent maternal complication in aTA group. Most common fetal complications were prematurity, IUGR and LBW in both groups (Table 1). Even fetal complications were more frequent in aTA group, it was not statistically significant [11 (33.3%) vs. 43 (21.5%), p=0.18 respectively]. However, maternal complications were significantly more common in aTA group [22 (11.0%) vs. 8 (24.2%), p=0.048]. There was no difference for the obstetrical outcomes in terms of novel TA classification. Conclusion: This study showed increased infertility and EM ratios in TA patients. PG of aTA had more complications in terms of maternal complications. Fetal complications were more frequent in PG of aTA but not statistically significant. Larger cohort data is required. References: [1]doi:10.1017/s0021932017000244. [2]doi:10.1016/j.maturitas.2019.03.008. Pregnancies p Before TA (n=200 ) After TA (n=33 ) Number of Patients 71 19 NP Age at TA diagnosis, years mean (SD) 38.2 (13.1) 24.0 (6.6) Age at first pregnancy 21.7 (5.0) 27.6 (5.0) Comorbidities/CV Risk factors n(% ) n (% ) p - Smoking 22 (31) 3 (15.8) &gt;0.05 - Dyslipidemia 14 (19.7) 1 (5.3) - Hypertension 29 (40.8) 9 (47.4) - Diabetes mellitus 8 (11.3) 0 (0) Maternal Complications n (% ) Numbers of pregnancies with any maternal complications 22 (11.0) 8 (24.2) 0.048 - Gestational hypertension 6 (3.0) 4 (12,1) NP - PROM 6 (3.0) 1 (3.0) - GDM 0 (0) 0 (0) - Bleeding (Antepartum/postpatum) 6 (3.0) 2 (6.1) - Preeclampsia 0 (0.0) 0 (0.0) - İnfection 5 (2.5) 1 (3.0) - Placenta previa 0 (0) 1 (3.0) Fetal Complications n (% ) p Numbers of pregnancies with any fetal complications 43 (21.5) 11 (33.3) 0.180 - LBW 16 (8.0) 6 (18.2) NP - IUGR 20 (1.0) 5 (15.2) - Preterm birth 13 (6.5) 7 (21.2) - CNS complications 2 (1.0) 1 (3.0) - Cardiovascular complications 3 (1.5) 0 (0) - RDS_BPD 4 (2.0) 0 (0) - NICU admission 12 (6.0) 1 (3.0) - Other 5 (2.5) 0 (0) - Neonatal death 5 (2.5) 0 (0) - Retinopathy of prematurity 1 (0.5) 0 (0) - Stillbirth 7 (3.5) 0 (0) Delivery n (% ) P Vaginal delivery 128 (64) 6 (18.2) &lt;0.001 Cesarean 24 (12) 13 (39.4) &lt;0.001 Spontaneous abortus 21 (10.5) 7 (21.2) 0.088 Termination of pregnancy 18 (9.0) 7 (21.2) 0.061 Abbreviations: BPD: Bronchopulmonary dysplasia, CNS: Central nervous system, GDM: Gestational diabetes mellitus, IUGR: Intrauterin growth restriction, LBW: Low birth weight, NICU: Neonatal Intensive Care Unit, NP: Not performed PROM: Premature rupture of membranes, RDS: Respiratory distress syndrome Disclosure of Interests: None declared