Abstract：
Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), namely granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis constitute a group of rare systemic vasculitides, affecting small vessels. Genders are equally affected, with symptoms most commonly presenting during and/or after the fifth decade of life, but AAV may also present in younger individuals. As advanced maternal age is becoming common and safe over the last decades, it is now more feasible for middle-aged women suffering from AAV to get pregnant. Although adverse pregnancy outcomes have been thoroughly investigated in other systemic diseases, the exact prevalence of pregnancy complications and unfavorable outcomes in pregnant women with AAV has not been systematically evaluated.
We researched PubMed, Scopus, Cochrane Library and Cinahl databases until September, 2022. Three blinded investigators extracted data and assessed the risk of bias. A random effects model was used for the analysis. The outcomes studied were pre-term delivery, intrauterine growth restriction (IUGR) neonates and disease flare.
We included six studies with 92 pregnancies in patients with AAV. The prevalence of pre-term delivery, IUGR neonates and disease flare were 18% (CI: 0.10-0.30, P=non-significant), 20% (CI: 0.11-0.33, P=non-significant) and 28% (CI: 0.09-0.59, P<0.01), respectively.
The analysis demonstrated higher occurrence of adverse outcomes in pregnant women suffering from AAV accompanied by an increased risk of disease flare during pregnancy. These findings underline the importance of preconception counseling and the necessity of close monitoring in these patients similarly to other systemic inflammatory diseases.
We researched PubMed, Scopus, Cochrane Library and Cinahl databases until September, 2022. Three blinded investigators extracted data and assessed the risk of bias. A random effects model was used for the analysis. The outcomes studied were pre-term delivery, intrauterine growth restriction (IUGR) neonates and disease flare.
We included six studies with 92 pregnancies in patients with AAV. The prevalence of pre-term delivery, IUGR neonates and disease flare were 18% (CI: 0.10-0.30, P=non-significant), 20% (CI: 0.11-0.33, P=non-significant) and 28% (CI: 0.09-0.59, P<0.01), respectively.
The analysis demonstrated higher occurrence of adverse outcomes in pregnant women suffering from AAV accompanied by an increased risk of disease flare during pregnancy. These findings underline the importance of preconception counseling and the necessity of close monitoring in these patients similarly to other systemic inflammatory diseases.
摘要：
目的：抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV），即肉芽肿性多血管炎，嗜酸性肉芽肿性血管炎和显微镜下多血管炎构成一组罕见的系统性血管炎，影响小血管。性别同样受到影响，在生命的第五个十年期间和/或之后最常见的症状，但AAV也可能存在于年轻个体中。在过去的几十年里，随着高龄产妇的年龄变得越来越普遍和安全，现在，患有AAV的中年妇女怀孕更可行。尽管不良妊娠结局已在其他系统性疾病中进行了彻底调查，AAV孕妇的妊娠并发症和不良结局的确切发生率尚未得到系统评估.
方法：我们研究了PubMed，Scopus,Cochrane图书馆和Cinahl数据库直到9月，2022年。三名失明的研究人员提取了数据并评估了偏倚的风险。使用随机效应模型进行分析。研究的结果是早产，宫内生长受限（IUGR）新生儿和疾病发作。
结果：我们纳入了6项研究，92例AAV患者妊娠。早产的患病率，新生儿IUGR和疾病发作为18％（CI：0.10-0.30，P=无统计学意义），20%(CI:0.11-0.33,P=无显著性)和28%(CI:0.09-0.59,P<0.01),分别。
结论：分析表明，患有AAV的孕妇的不良结局发生率更高，并伴有妊娠期疾病发作风险增加。这些发现强调了孕前咨询的重要性以及对这些患者进行密切监测的必要性，与其他全身性炎症性疾病类似。
方法：我们研究了PubMed，Scopus,Cochrane图书馆和Cinahl数据库直到9月，2022年。三名失明的研究人员提取了数据并评估了偏倚的风险。使用随机效应模型进行分析。研究的结果是早产，宫内生长受限（IUGR）新生儿和疾病发作。
结果：我们纳入了6项研究，92例AAV患者妊娠。早产的患病率，新生儿IUGR和疾病发作为18％（CI：0.10-0.30，P=无统计学意义），20%(CI:0.11-0.33,P=无显著性)和28%(CI:0.09-0.59,P<0.01),分别。
结论：分析表明，患有AAV的孕妇的不良结局发生率更高，并伴有妊娠期疾病发作风险增加。这些发现强调了孕前咨询的重要性以及对这些患者进行密切监测的必要性，与其他全身性炎症性疾病类似。
