Pregnancy Outcomes in Anti Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Systematic Review [37L]

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Information on pregnancy outcomes in Anti Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis is limited to small case series. We systematically reviewed the literature to determine pregnancy outcomes in women with ANCA-associated vasculitis, to help with counselling and management of these women.


We searched Medline, Embase, Web of Science and PubMed from inception until July 2017, using keywords and subject headings related to pregnancy and ANCA-associated vasculitis. Abstract screening, data extraction and risk of bias assessment using the National Institute of Health tool for case reports and case series were performed in duplicate. Vasculitis- and pregnancy-related outcomes were obtained, and pooled incidence (95% confidence intervals) calculated.


After screening 628 titles and 183 full texts, we included nine studies reporting 124 pregnancies in 89 women. Most studies (77.8%) had low risk of bias. There were 119 (91%) live births with a mean gestational age of 38.24 (37.35, 39.14) weeks and birth weight of 3.16 (2.95, 3.38) kg. Vasculitis flares were mostly in the ear, nose and throat 12.7% (4.9, 20.6%) and lungs 8.9% (2.9, 14.8%). Most patients were on glucocorticoids (43.5%) and/or Azathioprine (24.2%), increased doses of which successfully treated flares. Adverse outcomes included prematurity 10.3% (3.5, 17.1%), preeclampsia 5.5% (1.4, 9.5%), fetal growth restriction 4.9% (0.9, 8.9%) and congenital anomalies 3.7% (0.3, 7%).


Women with ANCA-associated vasculitis can be assured that despite large numbers of flares during pregnancy, severe flares are rare and easily managed by high-dose glucocorticoids and immunosuppressants. Pregnancy outcomes are comparable to low-risk populations, apart from an increased risk of preterm birth.

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