The Impact of Psoriasis on Pregnancy Outcomes

Abstract

Psoriasis is an inflammatory disease that affects women in their reproductive years. Other similar diseases have been associated with adverse pregnancy outcomes. We sought to assess whether pregnant women with psoriasis are at higher risk of developing complications, such as preterm birth (PTB) and low birth weight (LBW). A retrospective cohort, performed at two large tertiary centers, evaluated the outcomes of 162 pregnancies in 122 women with psoriasis and 501 pregnancies in 290 women without psoriasis. Univariable and multivariable analyses, adjusting for important demographic factors, comorbidities, or a propensity score, were performed to evaluate the association of psoriasis and a poor outcome composite (POC), including PTB (<37 gestational weeks) and LBW (<2,500 g). Repeated measures analysis was used to account for the multiple pregnancies per woman. Cesarean delivery, preeclampsia/eclampsia, and spontaneous abortion were also evaluated. For women with psoriasis, there was a 1.89-fold increase in odds of POC (95% CI 1.06-3.39) in the univariable analysis. This effect remained statistically significant in the multivariable analyses. Psoriasis was not associated with cesarean delivery, preeclampsia/eclampsia, and spontaneous abortion. This study has shown higher odds of POC in patients with psoriasis. Further larger population-based studies are required to confirm these findings.

Treating Psoriasis During Pregnancy: Safety and Efficacy of Treatments

“…In a large Danish prospective cohort study of 100,418 pregnancies with a prevalence of psoriasis of 3 %, mild to moderate psoriasis was not found to be a risk factor for fetal death after the first trimester or for prolonged time to pregnancy [23]. This is also in line with Lima et al [24], who found no increased risk of spontaneous abortions in pregnant women with psoriasis.…”

Inflammatory and glandular skin disease in pregnancy

“…11 Another study found that women with psoriasis had increased odds for preterm birth and low birth weight, but the values were not statistically significant. 13 That study found similar rates of pre-eclampsia, caesarean delivery, and history of spontaneous abortions between pregnant women with psoriasis and controls. 13 These results must be interpreted with consideration of the comorbidities associated with psoriasis.…”

“…13 That study found similar rates of pre-eclampsia, caesarean delivery, and history of spontaneous abortions between pregnant women with psoriasis and controls. 13 These results must be interpreted with consideration of the comorbidities associated with psoriasis.…”

Psoriasis and the Life Cycle of Persistent Life Effects

“…26 In a retrospective cohort study, psoriasis patients had a greater odds of a poor outcome composite (preterm birth and low birth weight), but not associated cesarean delivery, preeclampsia/eclampsia, or spontaneous abortion. 27 When comparing more than 3000 pregnancies in women with inflammatory skin disease to those without, there was no difference in incidence or outcome of pregnancy. 28 In 1 study, pregnant women with psoriasis (mean age, 32) were more likely to smoke, have a diagnosis of depression, and be overweight or obese before pregnancy, and were less likely to take preconceptional vitamin supplements, suggesting that the increased risk for adverse outcomes may be related to comorbidities and health behaviors in women with psoriasis.…”