Maternal and neonatal outcomes of births to women with psoriasis: a population-based cohort of 13 million births

Krim, Dana; Gomolin, Arieh; Czuzoj‐Shulman, Nicholas; Abenhaim, Haim A.

doi:10.1080/14767058.2021.2020238

Cited by 2 publications

(4 citation statements)

References 57 publications

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“…Regarding other live birth outcomes, preterm births rates were higher than rates reported in the general European population (5%–9%) and PSOLAR (9.1%) 54,55 . The higher rate of preterm birth compared to the general population has been suggested in different studies in the psoriasis population 4,5 . However, the actual relationship between psoriasis and preterm birth remains unclear 56 .…”

Section: Discussionmentioning

confidence: 89%

“…54,55 The higher rate of preterm birth compared to the general population has been suggested in different studies in the psoriasis population. 4,5 However, the actual relationship between psoriasis and preterm birth remains unclear. 56 Further studies are needed to clarify whether there is an increased risk of preterm delivery due to exposure to biologic drugs or due to the disease itself.…”

Section: Discussionmentioning

confidence: 99%

“…The course of psoriasis can fluctuate throughout pregnancy as hormone levels change, and up to 23% of psoriatic women may experience flares or intense disease activity 3 . The pathophysiology is characterized by cytokine and chemokine dysfunction, especially elevated tumour necrosis factor (TNF)‐alpha, which may increase the risk of preterm delivery, intrauterine growth restriction, and miscarriage 4,5 . Thus, treatment with the optimal regimen is essential for the mother and the child.…”

Section: Introductionmentioning

confidence: 99%

“…tumour necrosis factor (TNF)-alpha, which may increase the risk of preterm delivery, intrauterine growth restriction, and miscarriage. 4,5 Thus, treatment with the optimal regimen is essential for the mother and the child. Specific treatment with biologics should control these adverse events by blocking the central proinflammatory cytokine pathways in the immunopathogenesis of the disease.…”

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confidence: 99%

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Exposure to biologic therapy before and during pregnancy in patients with psoriasis: Systematic review and meta‐analysis

Sánchez‐García,

Hernández‐Quiles,

de‐Miguel‐Balsa

et al. 2023

Acad Dermatol Venereol

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Biologicals have transformed the management of severe disease phenotypes in psoriasis and are often prescribed in women of childbearing age. However, information on safety of biologicals in pregnancy are lacking. We conducted a systematic review and meta‐analysis aimed to describe the characteristics and pregnancy outcomes in women with psoriasis exposed to biologics within 3 months before or during pregnancy, and to estimate the pooled prevalence of spontaneous, elective and total abortions, and congenital malformations in their newborns. Bibliographic searches were performed in the PubMed, Embase, Scopus and Web of Science databases up to 14 April 2022. No restrictions on sample size or publication date were applied. Review performance complied with PRISMA guidelines, and two reviewers assessed randomized controlled trials and nonrandomized studies reporting pregnancy outcomes in women exposed to biologics indicated for psoriasis during the pre‐gestational and/or gestational period. Studies focusing on rheumatologic or gastroenterological immune‐mediated inflammatory diseases were excluded. Regardless of data heterogeneity, a random‐effects model was used to pool prevalence estimates. We included 51 observational studies, involving 739 pregnancies exposed to approved biologics for psoriasis. Administration was mostly (70.4%) limited to the first trimester, and the most common drug was ustekinumab (36.0%). The estimated prevalence of miscarriage was 15.3% (95% confidence interval [CI] 12.7–18.0) and elective abortions, 10.8% (95% CI 7.7–14.3). Congenital malformations occurred in about 3.0% (95% CI 1.6–4.8) of live births exposed to biologics during pregnancy. Altogether, exposure to biologics for psoriasis during pregnancy and/or conception does not seem to be associated with an increased risk of miscarriage/abortion or congenital malformations, showing similar rates to the general population. These results suggest that biologic drugs are safe and pose an acceptable risk to the foetuses/neonates.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Exposure to biologic therapy before and during pregnancy in patients with psoriasis: Systematic review and meta‐analysis

Sánchez‐García,

Hernández‐Quiles,

de‐Miguel‐Balsa

et al. 2023

Acad Dermatol Venereol

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Impact of maternal psoriasis on adverse maternal and neonatal outcomes: a systematic review and meta-analysis

Rahmati,

Moameri,

Mohammadi

et al. 2023

BMC Pregnancy Childbirth

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Background There is a dearth of robust evidence regarding the correlation between psoriasis with maternal and neonatal outcomes, making it challenging to establish definitive recommendations for the management of these patients. This systematic review and meta-analysis aimed to review the evidence with regard to the impact of maternal psoriasis on maternal and neonatal outcomes. Methods Following the PRISMA guideline, a systematic search of English articles using PubMed, Embase, Scopus, ScienceDirect, Web of Science, Google Scholar, and the Cochrane Library was conducted. The search was performed from inception to 22nd of May 2022. Result A significant association was observed between psoriasis and maternal outcomes, including cesarean delivery [OR = 1.25 (95% CI: 1.13–1.30, p-value = 0.001)], (pre)eclampsia [OR = 1.29 (95% CI: 1.15–1.44, p-value = 0.0001)], gestational diabetes [Odds Ratio (OR) = 1.23 (95% Confidence Intervals (CI): 1.15–1.30, p-value = 0.001)], gestational hypertension [OR = 1.31 (95% CI: 1.18–1.45, p-value = 0.001)] and preterm birth [OR = 1.22 (95% CI: 1.10–1.35, p-value = 0.001)]. Also, there was a significant association between psoriasis and neonatal outcomes, including small for gestational age [OR = 1.07 (95% CI: 1.02–1.11, p-value = 0.053)], low birth weight [OR = 1.19 (95% CI: 1.02–1.38, p-value = 0.001)] and stillbirth [OR = 1.27 (95% CI: 1.04–1.55, p-value = 0.023)]. Conclusion Maternal psoriasis could negatively impact maternal and neonatal outcomes. Our results strengthen the importance of close monitoring of the mothers’ psoriasis status before and during pregnancy.

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Maternal and neonatal outcomes of births to women with psoriasis: a population-based cohort of 13 million births

Cited by 2 publications

References 57 publications

Exposure to biologic therapy before and during pregnancy in patients with psoriasis: Systematic review and meta‐analysis

Exposure to biologic therapy before and during pregnancy in patients with psoriasis: Systematic review and meta‐analysis

Impact of maternal psoriasis on adverse maternal and neonatal outcomes: a systematic review and meta-analysis

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