Veltri NL, et al. - Herein, maternal, fetal and pregnancy outcomes in pregnant women with de novo antibody-associated vasculitis (AAV) were determined by performing a systematic review of the literature and a local, retrospective chart review. As per findings, although pregnancies with de novo AAV do carry serious maternal risks but can run an uncomplicated course.

• Researchers performed a systematic review of the literature and a local, retrospective chart review of women with de novo antibody-associated vasculitis (AAV) in pregnancy.
• They searched Cochrane, Embase and PubMed databases and relevant conference abstracts and analyzed patient demographics, clinical presentation, management and outcomes (maternal, fetal and pregnancy-related).

• This analysis included a total of 27 cases of de novo AAV in pregnancy.
• As per data, women presented were from 5 to 39 weeks' gestation, of which a majority were in the second trimester (median 20 weeks).
• It was noted that the median gravida of women was 2 and the median parity was 1.
• Women received treatment with steroids (89%), cyclophosphamide (CYC) (37%), other immunosuppressive agents [azathioprine (AZA), IVIG, plasma exchange (PLEX)] or no therapy (11%).
• Researchers reported high rates of serious complications, including preeclampsia (29%) and maternal death (7%); however, most pregnancies resulted in live birth (73%).
• They also noted that prematurity was common; 73% of live births occurred prior to 37 weeks’ gestation and 40% prior to 34 weeks’ gestation.
• Findings demonstrated that the majority of infants were born in the third trimester (median 34.5 weeks).
• In addition to high rates of pregnancy termination (23%), researchers reported only one intrauterine death, shortly after initiation of therapy (4%).
• Rare incidence of congenital abnormalities was documented, with one infant having a solitary, pelvic kidney (6%) after maternal treatment with steroids, CYC and PLEX.
• After 2005, an increase in the use of PLEX, IVIG and AZA, whereas decreased CYC use was reported.
• In addition, data showed that remission often occurred postpartum (60%).