Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Few case reports and series suggest adverse pregnancy outcomes in patients with Takayasu Arteritis (TA). This study was undertaken to determine the frequency of complications occurring during pregnancy for women with TA and to compare these outcomes with the general obstetric population by using the largest inpatient care database.
Methods: By using the 2003-2011 Nationwide Inpatient Sample of Healthcare Cost and Utilization Project, we estimated the number of obstetric hospitalization, deliveries and caesarean deliveries in women between the age group 18-50 years. Patients hospitalized with TA as one of the diagnoses were identified. Demographic characteristics and in-hospital outcomes were recorded for both TA and control group. Then we compared maternal and pregnancy complications for all pregnancy-related admissions for women with and without TA. Multivariate logistic regression analysis was used to obtain adjusted odds ratio (OR).
Results: The total number of obstetric hospitalization was 42.32 million of which 348 were women with diagnosis of TA. The maternal age of TA population was higher (28.1 years) than that in the control group (27 years) (p < 0.001). After adjusting for potential confounders, maternal TA population had a significantly higher prevalence of hypertensive diseases. The prevalence of intrauterine growth retardation, preterm delivery and antepartum hemorrhage was higher in TA population but did not reach a statistical significance. However, the odds of cesarean delivery, premature rupture of membranes and postpartum hemorrhage was lower in TA population. The frequencies of the above outcomes along with Odds Ratio are provided in Table 1.
Conclusion: Based on our study of national cohort, we conclude that women with TA have a higher risk of adverse outcomes of pregnancy than do pregnant women without TA, especially the hypertensive complications. Thus close antenatal and post-delivery monitoring need to be performed in order to reduce complications. The other outcomes did not reach a statistical significance likely due to small number of TA patients. Further studies with larger number of patients are needed to examine these findings.
References:
|
Table 1. Obstetric Outcomes for Pregnancy Related Hospitalizations |
|||||
|
Variable |
All patients |
TA |
No TA |
OR |
P value |
|
No of patients |
42317648 |
348 |
42317300 |
NA |
|
|
Hypertensive diseases |
3757992 |
182(52.3%) |
3757810(8.9%) |
4.584 (CI 3.352- 6.268) |
<0.001 |
|
Cesarean Delivery |
11857999 |
78(22.4%) |
11857921(28%) |
0.592 (CI 0.444-0.789) |
<0.001 |
|
IUGR |
774439 |
18(5.2%) |
774421(1.8%) |
1.861 (CI 1.063-3.256) |
0.30 |
|
Preterm Delivery |
2798720 |
55(15.8%) |
2798665(6.6%) |
1.227 (CI 0.832-1.809) |
0.301 |
|
PROM |
1456334 |
24(6.9%) |
1456310(3.4%) |
0.434 (CI 0.161-1.167) |
0.98 |
|
Antepartum hemorrhage |
8632232 |
9(2.6%) |
863223(2%) |
1.479 (CI 0.762-2.871) |
0.247 |
|
Postpartum Hemorrhage |
1106420 |
10(2.9%) |
1106410(2.6%) |
0.568 (CI 0.226-1.430) |
0.230 |
|
Abbreviations: TA= Takayasu Arteritis; PROM= Premature Rupture of Membranes; IUGR= Intrauterine Growth Retardation; OR= Odds Ratio (95% Confidence Interval (CI)); NA= Not Applicable |
|||||
To cite this abstract in AMA style:
Kishore S, Mittal V, Majithia V. Obstetric Outcomes in Women with Takayasu Arteritis: Results from Nationwide Inpatient Sample Database 2003-2011 [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/obstetric-outcomes-in-women-with-takayasu-arteritis-results-from-nationwide-inpatient-sample-database-2003-2011/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/obstetric-outcomes-in-women-with-takayasu-arteritis-results-from-nationwide-inpatient-sample-database-2003-2011/