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Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women With Systemic Vasculitides: A Nationwide Population‐Based Cohort Study

Title: Risk of Hypertensive Disorders and Preterm Birth in Pregnant Women With Systemic Vasculitides: A Nationwide Population‐Based Cohort Study
Authors: Mettler, Camille; Beeker, Nathanael; Collier, Mathis; Le Guern, Véronique; Terrier, Benjamin; Chouchana, Laurent
Source: Arthritis & Rheumatology ; volume 76, issue 3, page 429-437 ; ISSN 2326-5191 2326-5205
Publisher Information: Wiley
Publication Year: 2024
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Objective Even though systemic vasculitides (SVs) affect primarily patients over 50 years of age, they can occur among women of childbearing age. Preterm birth (PTB) and hypertensive disorders are frequent complications of pregnancy in SVs. This study aims to evaluate the risk of hypertensive disorders and PTB among pregnant women with SVs, and to identify associated risk factors. Method Using the French health insurance data warehouse, we conducted a nationwide cohort study including all pregnancies between 2013 and 2018 in women with SVs. Theses pregnancies were matched to pregnancies among women without SVs. We estimated risk of hypertensive disorders and PTB risk during pregnancy among women with SVs and investigated associated risk factors using a nested case‐control design. Results Among 3,155,723 pregnancies, we identified 646 pregnancies in women with SVs, matched to 3,230 controls. SVs were significantly associated with hypertensive disorders (odds ratio [OR] 1.7, 95% confidence interval [95% CI] 1.3–2.2) and PTB (OR 1.8, 95% CI 1.4–2.3). Chronic renal failure before pregnancy, history of or treated arterial hypertension, the occurrence of vasculitides flare during pregnancy, and the subgroup of SVs were independently associated with the occurrence of hypertensive disorders. Maternal age at delivery, chronic renal failure before conception, and the occurrence of vasculitides flare during pregnancy were independently associated with the occurrence of PTB. Conclusion About one of seven pregnancies in women with SVs is associated with hypertensive disorders or preterm birth. The occurrence of vasculitides flare was associated with these complications. Our findings support the importance of prepregnancy counseling to ensure disease stability. image
Document Type: article in journal/newspaper
Language: English
DOI: 10.1002/art.42747
Availability: http://dx.doi.org/10.1002/art.42747
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.CF9BB570
Database: BASE