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Background: Behçet’s Syndrome (BS) is a chronic, multisystemic inflammatory vasculitis with unknown etiology, generally diagnosed at reproductive age. Data related to disease manifestations and pregnancy outcomes are limited.
Objectives: To investigate disease manifestations during pregnancy and adverse pregnancy outcomes (APOs) in female patients with BS.
Methods: In this single centre study, 110 voluntary women who had long-term follow-ups in Ankara University Multidiciplinary Behçet outpatient clinic and their 323 pregnancies were evaluated. Patients were interviewed about their previous pregnancies. As 238 of 323 (73.6%) pregnancies were before BS diagnosis and additional 13 pregnancies were terminated due to family planning, we evaluated disease manifestations and APOs of 72 pregnancies. APOs were defined as spontaneus abortion, intrauterine exitus, stillbirth, premature rupture of membranes (PROM), intrauterine growth restriction/small for gestational age (IUGR/SGA), gestational diabetes mellitus (GDM), macrosomia, preeclampsia and eclampsia, arteriovenous thrombosis, congenital malformations and Rh incompatibility.
Results: A total of 30 APOs in 72 (41.7%) pregnancies was stated by participants (
The characteristics of pregnancies with and without APOs
| Pregnancy without APOs (n=42, 58.3% ) | Pregnancy with APOs (n= 30, 41.7% ) | P value | ||
|---|---|---|---|---|
| Maternal characteristics | Gestational age, years mean (SD) | 24.4 (5.6) | 24.5 (5.9) | 0.85 |
| Disease duration, years mean (SD) | 6.5 (10.4) | 7.9 (10.3) | 0.21 | |
| APOs and other complications | Spontaneous abortion, n(%) | 4 (13.3%) | ||
| Stilbirth, n(%) | 1 (3.3%) | |||
| IUGR-SGA, n(%) | 8 (26.7%) | |||
| Preeclampsia, n(%) | 3 (10.0%) | |||
| PROM, n(%) | 5 (16.7%) | |||
| Termination due to teratogens, n(%) | 4 (13.3%) | |||
| Trombosis, n(%) | 2 (6.7%) | |||
| GDM, n(%) | 3 (10.0%) | |||
| Macrosomia, n(%) | 4 (13.3%) | |||
| Rh incompatibility, n(%) | 3 (10.0%) | |||
| Drug use in pregnancy | Colchicine, n(%) | 11 (26.1%) | 8 (26.6%) | 0.96 |
| Azathioprine n(%) | 2 (6.7%) | |||
| Corticosteroids, n(%) | 1 (3.3%) | |||
| Neonatal outcomes | Median birth week, median (Q1-Q3)* | 39.0(38.0-40.0) | 38.0(33.5-39.0) | 0.001 |
| Median birth weight, grams, median (Q1-Q3)** | 3445.0(3123.8-3600.0) | 2850.0(2500.0-3700.0) | 0.038 | |
SD=Standart Deviation
*Calculations were done in 42 pregnancies of the group without APOs and in 26 pregnancies of the group with APOs
**Calculations were done in 40 pregnancies of the group without APOs and in 21 pregnancies of the group with APOs
The effects of medications during pregnancies were also examined. There were 19 pregnancies, in which colchicine was continued. When the pregnancies were compared between continued and cessation groups, median birth weights at continued and cessation groups were 3450 (Q1-Q3: 3125-3450) grams and 3300 (Q1-Q3: 2900-3820) grams (p=0.42), respectively. There was not any statistical difference between median birth weeks of continued and cessation groups 38.0 (Q1-Q3: 38.0-39.0) weeks at continued group and 39.0 (Q1-Q3: 38.0-40.0) weeks at cessation group (p=0.18)).There were not any significant differences between two groups in terms of exacerbated manifestations of BS and APOs (p values were 0.90 and 0.96, respectively). Azathioprine was used in 2 (2.7%) pregnancies, which resulted in termination and spontaneous abortion.
Conclusion: In this study, we found that APOs occurred in almost half of BS patients and colchicine use seemed to be safe throughout pregnancy. Some BS manifestations exacerbated and even occurred de novo during pregnancies. Prospective studies are needed to reveal the effects of BS and drugs on pregnancy.
Disclosure of Interests: None declared