Pregnancy outcome in patients with a medical history of immunoglobulin A vasculitis: a case-control study

Scand J Rheumatol. 2024 Jan;53(1):36-43. doi: 10.1080/03009742.2023.2226518. Epub 2023 Jul 13.

Abstract

Objective: Data on obstetric outcomes in patients with a history of immunoglobulin A vasculitis (IgA-V) are lacking. The aim of this study was to assess maternal, neonatal, and vasculitis outcomes during pregnancy.

Method: We conducted a French retrospective case-control study. Pregnancies of patients with a history of IgA-V (cases) were retrospectively studied and compared to pregnancies in women who developed IgA-V after their pregnancies and to pregnancies in healthy women (controls).

Results: Twenty-six pregnancies in patients with a history of IgA-V were included and compared to 15 pregnancies in women who later developed IgA-V and 52 pregnancies in healthy women. Both gestational hypertension and pre-eclampsia were more frequent in the case group than in the other groups (23% vs 0% vs 0%, p < 0.01; 12% vs 7% vs 0%, p = 0.04). Hypertensive disorder of pregnancy occurred more frequently in patients with pre-existing kidney disease (78% vs 12%, p < 0.01). Caesarean section was more often performed in the case group than in the other groups (27% vs 0% vs 10%, p = 0.04). No foetal loss or maternal deaths occurred. There were no differences in delivery term or birth weight. No vasculitis flares were observed during pregnancy.

Conclusion: Women with a history of IgA-V appear to be at higher risk for gestational hypertension and pre-eclampsia, especially in cases with renal involvement; however, both mother and newborn outcomes appear to be favourable.

MeSH terms

  • Case-Control Studies
  • Cesarean Section
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced* / epidemiology
  • IgA Vasculitis*
  • Immunoglobulin A
  • Infant, Newborn
  • Pre-Eclampsia* / epidemiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Vasculitis* / epidemiology

Substances

  • Immunoglobulin A