Pregnant Women with Psoriasis at Increased Risk of Ectopic Pregnancy: Study

The chronic systemic inflammation associated with psoriasis supposedly creates an undesirable milieu for a pregnancy, resulting in an increased risk of adverse pregnancy outcomes (APOs). A study was conducted to investigate the association between psoriasis and APOs and how the association differs according to psoriasis severity (mild and moderate-to-severe). This nationwide register-based case-control study collected data from 1973 to 2017. Cases were adverse pregnancy outcomes (spontaneous abortion, ectopic pregnancy [EP], intrauterine fetal death, and stillbirth). Singleton live births were controlled. Adjusted logistic regression models were used for statistical analyses.

Results of the study:

In total, 42,041 (8.56%) APOs and 449,233 (91.44%) controls were included. Ectopic pregnancy was the only adverse pregnancy outcome that was found to be statistically associated with psoriasis (odds ratio, 1.34; 95% CI, 1.06-1.68). Odds ratio for ectopic pregnancy was the highest for women with moderate-to-severe psoriasis (odds ratio, 2.77; 95% CI, 1.13-6.76). The absolute risk of Ectopic pregnancy was 2.48% higher for women with moderate-to-severe psoriasis compared with women without psoriasis (3.98% vs 1.50%).

Limitations of the study:

No access to clinical data confirming psoriasis severity.

Thus, the present study found a significant association between EP and psoriasis (absolute risk of 3.98%). As EP is the leading cause of maternal morbidity and mortality in the first trimester of pregnancy, our findings call for particular care for women of reproductive age with psoriasis.

Reference:

Psoriasis and adverse pregnancy outcomes: A nationwide case-control study in 491,274 women in Denmark by Cæcilie Bachdal Johansen, et al. published in the JAAD International.

https://www.jaadinternational.org/article/S2666-3287%2822%2900038-4/fulltext#%20

Keywords:

Psoriasis, adverse, pregnancy, outcomes, nationwide, case-control, study, women, Denmark, Cæcilie Bachdal Johansen, Alexander Egeberg, Espen Jimenez-Solem, Lone Skov, Simon Francis Thomsen, JAAD International, adverse pregnancy outcomes, ectopic pregnancy, fetal death, pregnancy outcome, psoriasis, psoriasis severity, spontaneous abortion, stillbirth, women