Pregnancy outcomes in women with a history of immunoglobulin A vasculitis

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Abstract

Objectives. Case series suggest an increased risk of pregnancy complications in women with a history of IgA vasculitis (IgAV); however, no large quantitative studies have examined this possible association to date. We compared pregnancy rates and outcomes between female IgAV patients and controls and assessed flare risk of IgAV during pregnancy. Methods. Using state-wide hospital morbidity data we compared rates for live birth, preterm birth, abortive outcome and gestational complications between female IgAV patients (International Classification of Diseases-9-Clinical Modification 287.0; International Classification of Diseases-10-Australian Modification D69.0) (n = 121) and non-exposed age-matched controls (n = 284) in Western Australia. Results presented are means compared by KruskalWallis test and proportions with odds ratios (ORs) (95% CI) compared by 2 testing. Results. There were 247 pregnancies in IgAV patients during which no disease flares were recorded and 556 pregnancies in controls. IgAV patients were younger at first pregnancy (24.7 vs 27.0 years, P & 0.01) and had 43 unsuccessful pregnancies (17.4%) and 204 live births with 17 preterm deliveries (8.3%). Women with IgAV had increased odds of spontaneous abortion (OR 1.9, 95% CI 1.1, 3.1, P = 0.04), preterm delivery (OR 2.0, 95% CI 1.1, 3.9, P = 0.02) and gestational hypertension (OR 4.7, 95% CI 2.3, 9.8). While gravidity did not differ (mean pregnancy number 2.4 vs 2.3, P = 0.36), IgAV patients had over a two-fold greater number of obstetric visits than controls (5.1 vs 2.5, P & 0.01). Conclusions. Hospitalization for IgAV has little impact on fertility and IgAV rarely flares during pregnancy. However, a history of IgAV associates with increased odds of spontaneous abortions, gestational hypertension and preterm delivery.

Original languageEnglish
Pages (from-to)884-888
Number of pages5
JournalRheumatology (United Kingdom)
Volume58
Issue number5
DOIs
Publication statusPublished - 1 May 2019

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Pregnancy Outcome
Vasculitis
Immunoglobulin A
Pregnancy
Odds Ratio
Pregnancy Induced Hypertension
Live Birth
International Classification of Diseases
Spontaneous Abortion
Gravidity
Western Australia
State Hospitals
Pregnancy Complications
Premature Birth
Pregnancy Rate
Obstetrics
Fertility
Hospitalization
Morbidity

Cite this

@article{5a193df225f54d749edd19fb886fb819,
title = "Pregnancy outcomes in women with a history of immunoglobulin A vasculitis",
abstract = "Objectives. Case series suggest an increased risk of pregnancy complications in women with a history of IgA vasculitis (IgAV); however, no large quantitative studies have examined this possible association to date. We compared pregnancy rates and outcomes between female IgAV patients and controls and assessed flare risk of IgAV during pregnancy. Methods. Using state-wide hospital morbidity data we compared rates for live birth, preterm birth, abortive outcome and gestational complications between female IgAV patients (International Classification of Diseases-9-Clinical Modification 287.0; International Classification of Diseases-10-Australian Modification D69.0) (n = 121) and non-exposed age-matched controls (n = 284) in Western Australia. Results presented are means compared by KruskalWallis test and proportions with odds ratios (ORs) (95{\%} CI) compared by 2 testing. Results. There were 247 pregnancies in IgAV patients during which no disease flares were recorded and 556 pregnancies in controls. IgAV patients were younger at first pregnancy (24.7 vs 27.0 years, P & 0.01) and had 43 unsuccessful pregnancies (17.4{\%}) and 204 live births with 17 preterm deliveries (8.3{\%}). Women with IgAV had increased odds of spontaneous abortion (OR 1.9, 95{\%} CI 1.1, 3.1, P = 0.04), preterm delivery (OR 2.0, 95{\%} CI 1.1, 3.9, P = 0.02) and gestational hypertension (OR 4.7, 95{\%} CI 2.3, 9.8). While gravidity did not differ (mean pregnancy number 2.4 vs 2.3, P = 0.36), IgAV patients had over a two-fold greater number of obstetric visits than controls (5.1 vs 2.5, P & 0.01). Conclusions. Hospitalization for IgAV has little impact on fertility and IgAV rarely flares during pregnancy. However, a history of IgAV associates with increased odds of spontaneous abortions, gestational hypertension and preterm delivery.",
keywords = "Caesarean, Gestational hypertension, IgA vasculitis, Pregnancy, Spontaneous abortion",
author = "Johannes Nossent and Warren Raymond and Helen Keen and Charles Inderjeeth and David Preen",
year = "2019",
month = "5",
day = "1",
doi = "10.1093/rheumatology/key408",
language = "English",
volume = "58",
pages = "884--888",
journal = "Rheumatology (United Kingdom)",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "5",

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TY - JOUR

T1 - Pregnancy outcomes in women with a history of immunoglobulin A vasculitis

AU - Nossent, Johannes

AU - Raymond, Warren

AU - Keen, Helen

AU - Inderjeeth, Charles

AU - Preen, David

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Objectives. Case series suggest an increased risk of pregnancy complications in women with a history of IgA vasculitis (IgAV); however, no large quantitative studies have examined this possible association to date. We compared pregnancy rates and outcomes between female IgAV patients and controls and assessed flare risk of IgAV during pregnancy. Methods. Using state-wide hospital morbidity data we compared rates for live birth, preterm birth, abortive outcome and gestational complications between female IgAV patients (International Classification of Diseases-9-Clinical Modification 287.0; International Classification of Diseases-10-Australian Modification D69.0) (n = 121) and non-exposed age-matched controls (n = 284) in Western Australia. Results presented are means compared by KruskalWallis test and proportions with odds ratios (ORs) (95% CI) compared by 2 testing. Results. There were 247 pregnancies in IgAV patients during which no disease flares were recorded and 556 pregnancies in controls. IgAV patients were younger at first pregnancy (24.7 vs 27.0 years, P & 0.01) and had 43 unsuccessful pregnancies (17.4%) and 204 live births with 17 preterm deliveries (8.3%). Women with IgAV had increased odds of spontaneous abortion (OR 1.9, 95% CI 1.1, 3.1, P = 0.04), preterm delivery (OR 2.0, 95% CI 1.1, 3.9, P = 0.02) and gestational hypertension (OR 4.7, 95% CI 2.3, 9.8). While gravidity did not differ (mean pregnancy number 2.4 vs 2.3, P = 0.36), IgAV patients had over a two-fold greater number of obstetric visits than controls (5.1 vs 2.5, P & 0.01). Conclusions. Hospitalization for IgAV has little impact on fertility and IgAV rarely flares during pregnancy. However, a history of IgAV associates with increased odds of spontaneous abortions, gestational hypertension and preterm delivery.

AB - Objectives. Case series suggest an increased risk of pregnancy complications in women with a history of IgA vasculitis (IgAV); however, no large quantitative studies have examined this possible association to date. We compared pregnancy rates and outcomes between female IgAV patients and controls and assessed flare risk of IgAV during pregnancy. Methods. Using state-wide hospital morbidity data we compared rates for live birth, preterm birth, abortive outcome and gestational complications between female IgAV patients (International Classification of Diseases-9-Clinical Modification 287.0; International Classification of Diseases-10-Australian Modification D69.0) (n = 121) and non-exposed age-matched controls (n = 284) in Western Australia. Results presented are means compared by KruskalWallis test and proportions with odds ratios (ORs) (95% CI) compared by 2 testing. Results. There were 247 pregnancies in IgAV patients during which no disease flares were recorded and 556 pregnancies in controls. IgAV patients were younger at first pregnancy (24.7 vs 27.0 years, P & 0.01) and had 43 unsuccessful pregnancies (17.4%) and 204 live births with 17 preterm deliveries (8.3%). Women with IgAV had increased odds of spontaneous abortion (OR 1.9, 95% CI 1.1, 3.1, P = 0.04), preterm delivery (OR 2.0, 95% CI 1.1, 3.9, P = 0.02) and gestational hypertension (OR 4.7, 95% CI 2.3, 9.8). While gravidity did not differ (mean pregnancy number 2.4 vs 2.3, P = 0.36), IgAV patients had over a two-fold greater number of obstetric visits than controls (5.1 vs 2.5, P & 0.01). Conclusions. Hospitalization for IgAV has little impact on fertility and IgAV rarely flares during pregnancy. However, a history of IgAV associates with increased odds of spontaneous abortions, gestational hypertension and preterm delivery.

KW - Caesarean

KW - Gestational hypertension

KW - IgA vasculitis

KW - Pregnancy

KW - Spontaneous abortion

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U2 - 10.1093/rheumatology/key408

DO - 10.1093/rheumatology/key408

M3 - Article

VL - 58

SP - 884

EP - 888

JO - Rheumatology (United Kingdom)

JF - Rheumatology (United Kingdom)

SN - 1462-0324

IS - 5

ER -