Association between Behçet disease and pregnancy-related outcomes: A systematic review and meta-analysis

Behçet disease (BD) is a chronic autoinflammatory disorder characterized by systemic vasculitis. It is highly prevalent in women of reproductive age and may increase the risk of pregnancy-related complications. This study evaluated the impact of BD on maternal, obstetric, and fetal outcomes. A systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted for studies comparing pregnancy-related outcomes between women with BD and controls, up to January 27, 2025. A random-effects model was used for the meta-analysis, and results were calculated as Mantel-Haenszel risk ratios (MH RRs) with 95 % confidence intervals (CIs). Seven cohort studies comprising 498 BD pregnancies and 14,943,476 controls were included. BD was associated with significantly higher risks of thromboembolic events (MH RR = 19.480; 95 % CI = 9.839-38.567), miscarriage (MH RR = 2.736; 95 % CI = 1.026-7.297), cesarean delivery (MH RR = 1.442; 95 % CI = 1.253-1.658), fetal growth restriction (FGR; MH RR = 2.368; 95 % CI = 1.392-4.027), and fetal abnormalities (MH RR = 2.011; 95 % CI = 1.129-3.581). Subgroup analysis revealed a significantly higher risk of gestational diabetes mellitus in Asian women with BD (MH RR = 3.613; 95 % CI = 1.038-12.572). Pregnant women with BD have significantly increased risks of thromboembolic events, miscarriage, cesarean delivery, FGR, and fetal abnormalities. These findings underscore the importance of multidisciplinary care to optimize maternal and fetal outcomes.