Background/Purpose: There are limited data on the reproductive health of women with vasculitis. This study utilized a large, prospective, international vasculitis pregnancy registry to survey women during and after pregnancy to improve characterization of reproductive outcomes.

Methods: The Vasculitis Pregnancy Registry (VPREG) is imbedded within the online Vasculitis Patient-Powered Research Network (VPPRN). Any pregnant woman with a diagnosis of vasculitis can self-enroll. After enrollment, women are invited to complete online surveys at study entry, once each trimester, and post-partum. Survey questions are organized into three categories: pregnancy outcomes and complications, vasculitis medications, and disease activity. VPREG surveys are currently available in five languages.

Results: Since 2015, 147 women with 149 pregnancies have enrolled in VPREG from 16 countries. Seventy-one pregnancies were excluded as nine women have ongoing pregnancies and 62 women were lost to follow-up. Seventy-eight pregnancies have known pregnancy outcomes (live or non-live birth) and were included in this analysis. Of these 78 pregnancies, ANCA-associated vasculitis was the most frequently reported diagnosis (n=35, 45%) followed by Takayasu’s arteritis (n=15, 19%), Behcet’s (n=7, 9%), and other forms (n=21, 27%). During pregnancy, women experienced low pain related to vasculitis (scale 0-10, mean 3.1 ± 3.0) and preserved feelings of wellness (scale 0-10, mean 3.4 ± 3.1). Nineteen women reported experiencing a flare of vasculitis during pregnancy. Of the 15 women requiring hospitalization during pregnancy outside of delivery, four cited vasculitis activity as the indication for inpatient care. Most women (54/73, 74%) were prescribed medications for vasculitis during pregnancy with glucocorticoids (n=36) and azathioprine (n=18) being the most frequently prescribed. Four women were prescribed rituximab. Nineteen (26%) women took no medications to treat vasculitis during pregnancy. Seventy-six (97%) pregnancies resulted in live births. Of these live births, 63% delivered vaginally and 21% experienced a preterm delivery. The median gestational age at delivery was 38 weeks.

Conclusion: These results demonstrate that most women with vasculitis can have successful pregnancies. During pregnancy, a minority of women reported vasculitis flares or the need for hospitalization due to vasculitis. Medications to treat vasculitis are prescribed in most patients for disease control during pregnancy. These data can be used by rheumatologists to inform and facilitate discussions about reproductive health with women with vasculitis.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/reproductive-outcomes-for-women-with-vasculitis/