Pregnancy Loss History Is Associated with Systemic Involvement and Disease Activity in Women with Behçet's Disease: A Retrospective Cohort Study.

Background/Objectives: Behçet's disease (BD) is a systemic vasculitis frequently affecting women of childbearing age. However, the relationship between systemic manifestations and pregnancy loss remains unclear. This study evaluated the association between pregnancy loss history and systemic clinical characteristics in women with BD. Methods: This retrospective cohort study included 114 women with BD followed in a rheumatology outpatient clinic between January 2021 and December 2025. In total, 196 pregnancies were recorded. Women without a pregnancy history were excluded. Pregnancy loss was defined as any spontaneous loss, including biochemical pregnancy, miscarriage, or fetal death, excluding elective terminations. Disease activity was assessed using the Krause score, and univariable logistic regression was performed. Results: Among 97 women with a pregnancy history, 25 (25.8%) had at least one pregnancy loss. Compared with women without pregnancy loss, those with pregnancy loss had longer disease duration and higher Krause scores. Gastrointestinal involvement (OR 6.31, 95% CI 1.87-23.28, p = 0.0035) and ocular involvement (OR 3.93, 95% CI 1.44-10.89, p = 0.0076) were significantly associated with pregnancy loss history. Higher Krause scores were also associated with greater odds of pregnancy loss history. Conclusions: In women with BD, pregnancy loss history was associated with systemic organ involvement and higher disease activity, particularly gastrointestinal and ocular involvement. These findings should be interpreted cautiously in light of the retrospective design and univariable analyses, and they suggest that pregnancy loss history may be associated with greater systemic disease burden.