Pregnant Women With Psoriasis may have Higher Risk for Adverse Maternal, Pregnancy Outcomes

Women with psoriasis may have an increased risk for adverse maternal and pregnancy outcomes; however, fertility does not seem to be negatively affected, according to a study in Journal of the American Academy of Dermatology.

The population-based study used information from Swedish population registers: Multi-Generation Register (MGR), Medical Birth Register (MBR), Patient Register, Cause of Death Register and Total Population Register.

The researchers evaluated two separate study populations to examine reproductive patterns in women with and without psoriasis and to assess the association between psoriasis and maternal and pregnancy outcomes.

The first study included 1,667,583 women (33,488 with psoriasis) older than 40 years in 2009. It looked at reproductive history from the MGR, including age at first birth, time between births and final parity.

The second study looked at pregnancy characteristics and birth outcomes from the MBR in 1,464,517 births (15,975 exposed to maternal psoriasis) between 1992 and 2009. The information included malformations recorded in the Patient Register within 3 years of birth.

The researchers did not find evidence that fertility was negatively affected in women with psoriasis. The proportion of women without children was 12.1% in women with psoriasis compared with 12.8% in women without psoriasis. The age at first birth was 23.6 years in women with psoriasis vs. 24.6 years in those without psoriasis.

In maternal and pregnancy outcomes, the researchers found that maternal psoriasis was associated with an increased risk for pregnancy hypertension (OR = 1.37; 95% CI, 1.19-1.58), premature rupture of membranes (OR = 1.15; 95% CI, 1.04-1.27) and large for gestational age (OR = 1.11; 95% CI, 1.01-1.21).

The odds ratios for increased risk for preterm birth, stillbirth or neonatal mortality were not statistically significant. However, there was an association between maternal psoriasis and clef palate (OR = 1.69; 95% CI, 1.07-2.66) and unspecified malformations (OR = 1.08; 95% CI, 1.01-1.16) based on 19 cases and 862 cases, respectively.

“Our findings add to a growing body of evidence that the risk for some adverse maternal and pregnancy outcomes is elevated in women with psoriasis,” Mats Lambe, MD, PhD, of the department of medical epidemiology and biostatistics at Karolinska Institutet in Stockholm, and colleagues wrote. “Pregnancies in women with psoriasis may need special monitoring.”