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Obstetric outcomes in antineutrophil cytoplasmic antibody-associated vasculitis: An interview-based study in Northern India

1 Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
2 Department of Clinical and Experimental Sciences, Rheumatology and Immunology Unit, University of Brescia, ASST Spedali Civili, Brescia, Italy

Correspondence Address:
Latika Gupta,
Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226 014, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/injr.injr_232_21

Introduction: Rheumatic diseases are associated with poor obstetric outcomes, especially in developing countries. In a multisystem disease like antineutrophil cytoplasmic antibody-associated vasculitis (AAV), pulmonary and renal involvement may contribute to adverse pregnancy outcomes. we explored pregnancy outcomes in women with AAV and compared pregnancies after disease onset to those that occurred before it. Method: Women with AAV (Chapel Hill Criteria, 2012) registered at a tertiary care center (2001–2021) were interviewed by teleconsultation or during outpatient visits. Maternal complications and fetal complications were recorded. Results: Median age at disease onset was 48 (33–60) years, with the most common subtype being granulomatosis with polyangiitis (13, 48%) followed by microscopic polyangiitis (10, 37%). Twelve women were in the reproductive age group, of which six suffered from a premature menopause. Three pregnancies in three women after disease onset were compared with 62 pregnancies in 23 women with conception before the disease. Pregnancies before disease onset resulted in 58 (93.3%) live birth. One (33.33%) live birth was observed in the pregnancies after disease onset, and disease onset during pregnancy resulting in intrauterine death at 20 weeks period of gestation. One patient is currently in her antenatal period with no complications so far. This study suggests the absence of impact on pregnancy outcome before diagnosis of AAV. Conclusion: Pregnancy after a diagnosis of AAV is rare, and successful outcomes may be reported on occasion.

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