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

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.

Acknowledgements

We thank Professor Leslie Guillon (Public Health, CHU de Tours, Tours, France) and Carine Da Silva (Midwife, Obstetrics & Gynecology Department, CHU de Tours, Tours, France).

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics

The study was approved by the ethics committee of the Tours University Hospital, France (02/25/20) and the Commission Nationale de l’Informatique et des Libertés) (CNIL) (no. 2020_021). All patients received an information letter and could withdraw from the study at any time.

Data availability statement

The data that support the findings of this study are available from the corresponding author, A Audemard-Verger, upon reasonable request.

Additional information

Funding

No specific funding was received from any bodies in the public, commercial, or not-for-profit sectors to carry out the work described in this article.