Pregnancy outcome of patients with psoriasis Academic Article uri icon

abstract

  • EYAL SHEINER, MORDECHAI HALLAK, AMALIA LEVI, Soroka University Medical Center, Ob/Gyn, Beer-Sheva, Israel, Ben-Gurion University of the Negev, Faculty of Health Sciences, Epidemiology, Beer-Sheva, Israel OBJECTIVE: Psoriasis is one of the most common T cell-mediated autoimmune dermatologic diseases in humans. While immune disorders are known to have adverse effects on pregnancy, limited data exist regarding pregnancy outcome of women having psoriasis. The purpose of this study was to determine pregnancy outcome of patients with psoriasis. STUDY DESIGN: A case-control study of deliveries to women suffering from psoriasis (ICD-9 code 696.1; n=145) who delivered during the years 1988–2004 was conducted. For every birth, six births by non-psoriatic mothers (n=860) were randomly selected and adjusted for ethnicity and year of delivery. RESULTS: The following complications were significantly associated with pregnancies to psoriatic patients: recurrent abortions (6.9% vs. 3.3%; P!0.05), previous caesarean delivery (CD) (20.0% vs. 10.7%; P!0.01), severe preeclampsia (3.4% vs. 0.9%; P!0.05), chronic hypertension (4.8% vs. 1.5%; P!0.05), pre-gestational diabetes mellitus (4.1% vs. 1.2%; P!0.05), non-reassuring monitoring (5.5% vs. 1.7%; P!0.05), and labour dystocia (5.5% vs. 1.7%; P!0.05). Using a multivariable analysis, with backward elimination, only recurrent abortions (OR=2.1, 95% CI 1.1–4.9; P!0.05) and chronic hypertension (OR=2.9, 95% CI 1.01–8.3; P!0.05) were significantly associated with psoriasis.A higher rate of CD was found among the study group (35.2% vs. 15%; P!0.001). Another multivariable analysis was performed, with CD as the outcome variable, controlling for possible confounders such as previous CD, hypertensive disorders, labour dystocia etc. Psoriasis was found as an independent risk factor for CD (OR=4.1, 95% CI 2.3–7.5; P!0.001). No significant differences were noted between the groups regarding perinatal complications. CONCLUSION: Psoriasis was significantly associated with pregnancy complications such as recurrent abortions and chronic hypertension. Moreover, psoriasis was found to be an independent risk factor for CD. Thus, physicians should keep in mind that psoriasis might have non-dermatologic implications, which may adversely affect pregnancy.

publication date

  • January 1, 2005