Psoriasis and PsA in pregnancy have adverse maternal events but no neonatal events: Study

Psoriasis and PsA are inflammatory diseases that affect women in their reproductive years. Studies about the effects of pregnancy on psoriasis and those of psoriasis on pregnancy is limited, despite the high frequency of the disease in the general population.

A new study by Wenhui Xie and team reported that pregnant women with Psoriasis and Psoriatic Arthritis PsA have excess risk of adverse maternal events, but no adverse neonatal events. This study is published in Rheumatology journal.

The objective of the study was to investigate whether maternal psoriasis and PsA are associated with adverse pregnancy outcomes.

The study used multiple electronic databases from inception to 3 August 2020, and reference lists of selected articles. Observational studies reporting at least one pregnancy outcome in women with psoriasis or PsA with a comparator of general population or healthy subjects were included. Data were pooled by random-effects models and expressed as odds ratio (OR) and 95% CI.

The results of the study were found to be

• A total of 16 studies of pregnant women with psoriasis and/or psoriatic arthritis (46,909 patients, 53,541 pregnancies, 4,771,352 controls) were included.

• Multiple maternal adverse outcomes including cesarean delivery (OR, 1.33), preterm birth (OR, 1.32), gestational hypertension (OR, 1.30), preeclampsia/eclampsia (OR, 1.28).

• Gestational diabetes (OR, 1.19) were associated with psoriatic disease, whereas prematurity was the only neonatal adverse outcomes associated with psoriatic disease (OR 1.12 derived from only 2 studies).

• Results were similar when analyzed by psoriasis and psoriatic arthritis subgroups and the magnitude of risk estimates seems to be greater in PsA, though without statistical difference.

Xie and team concluded that "Pregnant women with psoriasis and PsA have excess risk of adverse maternal events, but not adverse neonatal events." They also stated that "Close monitoring of the mother's clinical status before and during pregnancy is decidedly required in daily practice."

For further information: https://doi.org/10.1093/rheumatology/keab357