Reproductive patterns and maternal and pregnancy outcomes in women with psoriasis—A population-based study - 03/02/20

Doi : 10.1016/j.jaad.2019.05.099

Mats Lambe, MD, PhD ^a,^b,^⁎ , Anna V. Bergstrom, MD ^c, Anna L.V. Johansson, PhD ^a, Caroline E. Weibull, PhD ^a,^d
^a Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
^b Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden
^c Dermatology Unit, Department of Medicine, University Hospital, Uppsala, Sweden
^d Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden

^∗Correspondence to: Mats Lambe, MD, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77 Stockholm, Sweden.Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetPO Box 281Stockholm171 77Sweden

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Abstract

Background

Data on pregnancy outcomes in women with psoriasis are conflicting.

Objective

We examined whether maternal psoriasis affects the risk of adverse maternal and pregnancy outcomes.

Methods

We used population-based data to compare reproductive patterns in women with and without psoriasis. Odds ratios (ORs) with 95% confidence intervals (CIs) for adverse outcomes were estimated with adjustments for maternal age, period of childbirth, smoking, and prepregnancy body mass index.

Results

Compared with women without psoriasis, women with psoriasis were younger at first birth and had longer interpregnancy intervals but did not differ in final parity. Risk estimates in women with psoriasis were elevated 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), large for gestational age (OR, 1.11; 95% CI, 1.01-1.21), cleft palate (OR, 1.69; 95% CI, 1.07-2.66), and unspecified malformations (OR, 1.08; 95% CI, 1.01-1.16).

Limitations

No information was available on lifestyle, disease severity, or type and duration of treatment. Small numbers hampered the assessment of rare outcomes.

Conclusion

Although there was no evidence that fertility is negatively affected, women with psoriasis were at an increased risk of several adverse maternal and pregnancy outcomes. Our findings add to a growing body of evidence that pregnancies in women with psoriasis need special monitoring.

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Key words : malformations, maternal outcomes, pregnancy outcomes, parity, psoriasis, register, Sweden

Abbreviations used : BMI, CI, ICD, ICD10 SE, MGR, MBR, OR

Plan

Methods

Data sources

Study design

Defining psoriasis, reproductive history, and birth outcomes

Statistical methods

Results

Reproductive patterns

Maternal characteristics

Maternal and pregnancy adverse outcomes

Malformations

Discussion

Reproductive patterns

Maternal and pregnancy outcomes

Malformations

Conclusion

	Drs Weibull and Johansson contributed equally to this article.
	Funding sources: Supported by an Investigator Initiated Research Grant from Pfizer Inc. (IIR WS2059711) and the Karolinska Institutet Research Funds. The sponsors had no role in the study design, data collection, data analysis, data interpretation or writing of the report.
	Disclosure: Dr Lambe owns stocks in AstraZeneca and Pfizer Inc. Drs Bergstrom, Johansson, and Weibull have no conflicts of interest to declare.
	Reprints not available from the authors.