Fertility and pregnancy in vasculitis

Area of Science:

• Rheumatology
• Obstetrics
• Reproductive Medicine

Background:

• Vasculitis, though rare, significantly impacts fertility and pregnancy outcomes.
• Limited data exists on the disease's direct effect on fertility, with more focus on therapies like cyclophosphamide.

Purpose of the Study:

• To explore fertility and pregnancy outcomes in patients with vasculitis.
• To highlight the importance of disease remission and specialized multidisciplinary care during pregnancy.

Main Methods:

• Review of existing literature on vasculitis and pregnancy.
• Analysis of maternal complications and pregnancy loss rates associated with specific vasculitides.
• Assessment of neonatal outcomes in pregnancies affected by maternal vasculitis.

Main Results:

• Maternal complications (hypertension, renal insufficiency, cardiac damage, airway stenosis) are often disease-related.
• Pregnancy loss rates vary by vasculitis type (e.g., GPA 10%, EGPA 20%, Behçet's 20-30%, TAK 25%).
• High rates of preterm births are observed; neonatal manifestations are rare and transient.

Conclusions:

• Pregnancy in vasculitis patients requires careful planning, ideally during remission.
• Multidisciplinary care involving high-risk obstetricians and rheumatologists is essential.
• While maternal complications exist, outcomes are generally favorable with appropriate management.