AB1283 HOW TO COUNSEL A WOMAN WITH BEHÇET’S DISEASE: RESULTS FROM A MONOCENTRIC COHORT OF WOMEN DIAGNOSED DURING CHILDBEARING AGE

Abstract

BackgroundPatients with autoimmune diseases require appropriate pregnancy counceling, as their disease can negatively impact both maternal and fetal outcomes. In regards to Behçet’s disease (BD), although commonly diagnosed during the childbearing age, only few studies focused on its impact on gestation, with contradictory results.ObjectivesWe aimed to collect new data on BD and its impact on pregnancy by designing a single-center cohort study, reporting the pregnancy and maternal outcomes in BD patients attending the Multidisciplinary Centre for Immunopathology and Rare Diseases at Giovanni Bosco Hospital (Turin, Italy).MethodsWe retrospectively included 26 women diagnosed with BD followed at our center. Out of 26 patients, data from 33 pregnancies in 16 women were collected. Ten patients were never pregnant. Table 1 shows the demographical and clinical characteristics and the pregnancy outcomes of the enrolled patients.Table 1.Clinical characteristics and pregnancy outcome of the Behçet’s disease patients enrolled in the study.Patients(tot=31)Nulliparous; n (%)10/26 (38,46%)Primigravida; n (%)16/26 (61,54%)DemographicsAge at BD diagnosis; mean± S.D.40,56±11,42Age at first pregnancy; mean ± S:D.24,86 ± 6,56Clinical characteristics of BDOral ulcers; n (%)26/26 (100 %)Genital ulcers; n (%)21/26 (80,76%)Folliculitis; n (%)15/26 (57,69%)Erythema nodosum; n (%)6/26 (23,08%)Ocular manifestations; n (%)11/26 (42,31%)HLA B-51+; n (%)13/26 (50%)Pregnancy outcomeRate of live births; n (%)27/33 (81,81%)Any complications; n (%)12/33(36,36%) Early miscarriage before 10 weeks of gestation; n (%)6/33 (18,18%) Gestational diabetes; n (%)3/33 (9,09%) Placental abruption; n (%)2/33 (6,06%) Vaginal bleeding before 20 weeks of gestation; n (%)1/33 (3,03%)Worsening of oral and genital ulcerations; n (%) *2/ 11 (18%)* This information was available only for 11/33 pregnancies.BD – Behçet’s diseaseS.D – Standard deviationResultsAll included patients fulfilled the international criteria for BD (1), with a median age at the time of diagnosis of BD and first pregnancy of 40,56±11,42 and 24,86±6,86 respectively. The frequency of clinical manifestations was oral ulcers (100%), genital ulcers (80,76%), erythema nodosum (23,08%), folliculitis (57,69%), ocular manifestations (42,31%) and HLA B-51+ (50%), respectively.The overall rate of live births was 81,81% (27/33). Twelve women experienced pregnancy complications (36,36%), in particular we report one case of vaginal bleeding before 20 weeks of gestation, six miscarriages before the 10th week of gestation, three cases of gestational diabetes and two placental abruptions. Among the analyzed pregnancies, a worsening of oral and genital ulcerations was observed in the 18% of them, while in the remaining cases a subjective amelioration of aphtosis and other concurrent symptoms was reported by the patients. No systemic flare, worsening of ocular complications and VTE was reported during pregnancy and in the post-partum period.ConclusionThe results of our study highlight an overall favorable rate of life births in BD women and a positive rate of disease remission in pregnancy. Currently, the studies focusing on pregnancy outcomes in BD are scarce, however it might be appropriate to give a specialized counseling to a BD woman planning for a pregnancy and follow these patients with a multidisciplinary approach.