大动脉炎妊娠风险研究分析

Analysis of pregnancy outcome and mother-child related concerns in patients with Takayasu arteritis

目的评估大动脉炎患者的妊娠结局，分析妊娠相关问题。方法回顾性分析了68例女性患者在大动脉炎疾病发病前后妊娠次数、分娩、妊娠结局。用调查问卷采集西京医院妇产科妊娠相关问题的信息。采用，检验进行统计学分析。结果68例女性大动脉炎患者怀孕106次，发病前妊娠73次（41例患者），发病后妊娠33次（28例患者）。大动脉炎发病前后患者的自然流产、人工流产、母体并发症出现的频次差异无统计学意义。大动脉炎患者妊娠期高血压综合征的发病率（4．7％）高于健康对照（2．0％），但差异无统计学意义（x^2=1．238，P〉0．05）；大动脉炎患者先兆子痫／子痫的发病率（4．7％）高于健康对照组（2．8％），但差异无统计学意义（x^2=1．835，P〉0．05）。大动脉炎发病后妊娠的平均怀孕周期是（37±6）周，低于健康对照组的（39±4）周，差异有统计学意义（x^2=14．665，P〈0．01）。大动脉炎发病后剖宫产率较健康对照组高（36％和15％，x^2=13．322，P〈0．01）。大动脉炎患者中，有86％询问过妊娠相关问题，其中72％是关于该组疾病对后代的影响。结论在大动脉炎患者中，母体与胎儿均有较好的妊娠结果。这个研究也提示大动脉炎患者对其妊娠问题较为关注。

Objective To assess pregnancy outcome and pregnancy related concerns in Takayasu arteritis （TA） patients. Methods We analyzed 68 female patients with TA retrospectively from Xijing hospital. Data on the number of pregnancies, births and pregnancy outcomes before and after disease onset were retrieved from medical charts, patient questionnaires and the department of Obstetrics in Xijing Hospital. Data on pregnancy related concerns were gathered from patient questionnaires. Results Altogether, 68 women in the TA study cohort had 106 pregnancies, 73 （in 41 patients） before disease onset and 33 （in 28 patients） after disease onset. There were no difference in the frequencies of miscarriages, induced abortions and maternal complications before and after TA onset. Pregnancy related hypertension was seen in 4.7% of the TA patients compared to 2.0% （x^2=1.238, P〉0.05） of the reference cohort from the department of Obstetrics in Xijing Hospital and preeclampsia/eclampsia in 4.7% of the TA patients compared to 2.8% of the reference cohort （x^2=1.835, P〉0.05）. The mean gestational age at delivery in pregnancies after TA onset was （37±6） weeks compared to （39±4） weeks in the reference cohort （x^2=14.665, P〈0.01）. Caesarian sections were more frequent in deliveries after TA onset （36%） than in the reference cohort （15%） （x^2=13.322, P〈0.01）. 86% of the TA patients had pregnancy related concerns. Of these concerns, 72% was about passing the disease to offsprings. Conclusion In this population based TA cohort, the maternal and fetal outcomes are favorable. Pregnancy related concerns are very popular in TAK patients.