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Resultados maternos y perinatales en vasculitis: un estudio de 15 años en un centro terciario multidisciplinario
Ana Rita Lopes1,2, Susana Capela1,2, Ana Rita Cruz-Machado1,2
1Rheumatology Department, ULS Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal.
Rheumatology advances in practice
|February 5, 2026
Resumen
El embarazo en mujeres con vasculitis puede ser exitoso si la enfermedad está en remisión. Sin embargo, el uso de prednisolona y la recaída de la enfermedad aumentan el riesgo de resultados adversos del embarazo (APO).
Área de la Ciencia:
- Reumatología
- Obstetricia
- Perinatología
Sus antecedentes:
- La vasculitis sistémica presenta desafíos únicos durante el embarazo.
- La comprensión de los resultados maternos y perinatales es crucial para el manejo de estos embarazos de alto riesgo.
Objetivo del estudio:
- Evaluar los resultados maternos y perinatales en mujeres con vasculitis.
- Identificar los factores de riesgo asociados con resultados adversos del embarazo (APO) en esta población.
Principales métodos:
- Un estudio retrospectivo de 39 embarazos en 28 mujeres con vasculitis sistémica (2009-2024).
- Los datos recopilados incluyeron características del paciente, actividad de la enfermedad (remisión/recaída), tratamiento y resultados del embarazo.
- Los resultados adversos del embarazo (APO) incluyeron aborto espontáneo, muerte fetal, parto prematuro, restricción del crecimiento fetal (FGR), pequeño para la edad gestacional (SGA) y preeclampsia.
- El análisis estadístico incluyó regresión logística univariada y multivariada para identificar factores de riesgo.
Principales resultados:
- La mayoría de los embarazos (92,3%) ocurrieron durante la remisión clínica.
- Los subtipos comunes de vasculitis incluyeron la enfermedad de Behçet, la poliarteritis nodosa y la arteritis de Takayasu.
- Los resultados adversos del embarazo (APO) ocurrieron en el 33,3% de los embarazos.
- El uso de prednisolona (OR 26,10) y las recaídas de la enfermedad durante el embarazo (OR 8,90) se asociaron de forma independiente con los APO.
- No se encontraron asociaciones significativas con la edad materna, la dosis acumulada de prednisona o el uso de inmunosupresores.
- No se informaron muertes maternas ni complicaciones neonatales graves.
Conclusiones:
- El embarazo en mujeres con vasculitis puede ser exitoso, especialmente cuando la concepción ocurre durante la remisión clínica.
- El uso de prednisolona y la recaída de la enfermedad durante el embarazo son factores de riesgo potenciales para resultados adversos del embarazo (APO).
- El asesoramiento preconcepcional y la atención multidisciplinaria son vitales para optimizar los resultados en mujeres embarazadas con vasculitis.
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