Abstract：
OBJECTIVE: This study aimed to understand the status quo of medical treatments of the primary disease and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children\'s birth outcomes.
METHODS: This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labor, and Welfare for Intractable Vasculitis.
RESULTS: This study enrolled 51 cases and 68 pregnancies 2019-2021. Of these, 48 cases and 65 pregnancies (95.6%) resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. Enlargement of an aneurysm was reported in one pregnancy, which might be associated with increased circulating plasma volume. TAK relapsed in 4 (6.2%) and 8 (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low birth weight infants were observed, and none had serious postnatal abnormalities. Of the 51 confirmed infants, 42 (82.4%) were exclusively breastfed or mixed with formula.
CONCLUSIONS: Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in <20% of pregnancies.
METHODS: This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labor, and Welfare for Intractable Vasculitis.
RESULTS: This study enrolled 51 cases and 68 pregnancies 2019-2021. Of these, 48 cases and 65 pregnancies (95.6%) resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. Enlargement of an aneurysm was reported in one pregnancy, which might be associated with increased circulating plasma volume. TAK relapsed in 4 (6.2%) and 8 (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low birth weight infants were observed, and none had serious postnatal abnormalities. Of the 51 confirmed infants, 42 (82.4%) were exclusively breastfed or mixed with formula.
CONCLUSIONS: Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in <20% of pregnancies.
摘要：
目的：本研究旨在了解大动脉炎（TAK）患者原发疾病的药物治疗现状及妊娠结局，以及儿童的出生结局。
方法：本研究回顾性招募了TAK患者，这些患者在疾病发作后受孕，并在参加卫生部日本研究委员会的医疗机构进行管理，劳工,以及顽固性血管炎的福利。
结果：本研究纳入了51例病例和68例2019-2021年怀孕。其中,48例和65例怀孕（95.6％）导致分娩和活产婴儿。诊断和分娩的中位年龄分别为22岁和31岁。孕前治疗包括泼尼松龙（PSL）51（78.5％，中位数7.5毫克/天)，18例免疫抑制剂（27.7%），和生物制剂在12（18.5％）怀孕。6例妊娠前行手术治疗。怀孕期间的药物包括48例PSL（73.8％，中位数：9毫克/天），免疫抑制剂13例（20.0%），9例（13.8%）怀孕中的生物制剂。据报道，在一次怀孕中动脉瘤增大，这可能与循环血浆体积增加有关。TAK在怀孕期间和分娩后的4例（6.2％）和8例（12.3％）妊娠中复发，分别。此外,观察到13/62（20.9%）早产儿和17/59（28.8%）低出生体重儿，没有人出现严重的产后异常。在51名确诊的婴儿中，42（82.4％）是纯母乳喂养或与配方混合。
结论：大多数TAK患者的妊娠在PSL≤10mg/天的情况下是可以控制的。怀孕期间和产后复发发生在<20%的怀孕中。
方法：本研究回顾性招募了TAK患者，这些患者在疾病发作后受孕，并在参加卫生部日本研究委员会的医疗机构进行管理，劳工,以及顽固性血管炎的福利。
结果：本研究纳入了51例病例和68例2019-2021年怀孕。其中,48例和65例怀孕（95.6％）导致分娩和活产婴儿。诊断和分娩的中位年龄分别为22岁和31岁。孕前治疗包括泼尼松龙（PSL）51（78.5％，中位数7.5毫克/天)，18例免疫抑制剂（27.7%），和生物制剂在12（18.5％）怀孕。6例妊娠前行手术治疗。怀孕期间的药物包括48例PSL（73.8％，中位数：9毫克/天），免疫抑制剂13例（20.0%），9例（13.8%）怀孕中的生物制剂。据报道，在一次怀孕中动脉瘤增大，这可能与循环血浆体积增加有关。TAK在怀孕期间和分娩后的4例（6.2％）和8例（12.3％）妊娠中复发，分别。此外,观察到13/62（20.9%）早产儿和17/59（28.8%）低出生体重儿，没有人出现严重的产后异常。在51名确诊的婴儿中，42（82.4％）是纯母乳喂养或与配方混合。
结论：大多数TAK患者的妊娠在PSL≤10mg/天的情况下是可以控制的。怀孕期间和产后复发发生在<20%的怀孕中。
