Clinical outcomes of hereditary angioedema on multiparous women

Significant concerns for patients with hereditary angioedema (HAE) include hormonal fluctuations and drug safety during pregnancy. The impact of the disease on childbearing in multiparous women remains to be elucidated. We aimed to investigate the clinical course and impacts of multiparity on HAE patients.

This observational study included 15 multiparous women with HAE; a total of 88 pregnancies were assessed using a questionnaire and the patient's medical records.

The median age was 36 (IQR, 33-39). Of 72 resulted in healthy babies without any congenital abnormalities. In sixteen pregnancies, 12 (13.6%) ended with spontaneous abortion; three resulted in stillbirth and one neonatal death. Two-thirds of the patients (n = 10) enounced a worsening in the frequency of angioedema attacks during pregnancy. There was no statistically significant difference compared with the nonpregnant period (p = 0.283). One-fifth of the patients (n = 3) reported alleviation in attacks. While most deliveries were vaginally (n = 57 babies), 19 deliveries in six patients were by cesarean section. None of the patients were aware of the diagnosis of HAE prior to their first pregnancies. After the diagnosis was made, eight patients received 263 vials of plasma-derived C1-inhibitor concentrate during a total of 13 pregnancies. No adverse events were reported.

We conclude that our results on clinical course and outcomes of HAE in multiparous patients are consistent with the literature. A greater focus on multiparous HAE patients could produce exciting findings.