Department of Dermatology, Taipei Medical University and Hospital, Taipei, Taiwan.
J Am Acad Dermatol. 2011 Jan;64(1):71-7. doi: 10.1016/j.jaad.2010.02.005.
Previous research regarding pregnancy outcomes in women with psoriasis either used selective hospital-based data, or analyzed obstetric, but not infant-specific, outcomes.
We sought to investigate whether maternal psoriasis was associated with increased risk of adverse pregnancy outcomes, compared with unaffected mothers, in an unselected nationwide population-based data set.
In total, 1463 mothers with psoriasis and 11,704 randomly selected mothers without psoriasis were included. Of the 1463 mothers with psoriasis, 645 (44.1%) who had received photochemotherapy or systemic therapy within 2 years before their index deliveries were put in the severe psoriasis group. Conditional logistic regression analyses were conducted to calculate the risk of low birth weight (LBW), preterm birth, cesarean section, small for gestational age, and preeclampsia or eclampsia for these two groups, after adjusting for characteristics of the mother, father, and infant.
The odds of LBW for women with severe psoriasis were 1.40 times those of mothers without psoriasis (95% confidence interval = 1.04-1.89) after adjusting for characteristics of the mother, father, and infant. However, mothers with mild psoriasis had no significantly higher odds of LBW, preterm birth, cesarean section, infants small for gestational age, and preeclampsia or eclampsia compared with those without psoriasis.
Patients with psoriasis were identified by diagnostic code in database, resulting in the possibility of misclassification bias. In addition, lack of information regarding maternal risk behaviors and previous adverse pregnancy outcomes may leave residual confounding.
We found that pregnant women with severe psoriasis had an increased risk of LBW infants, whereas mild psoriasis was not associated with excess risk of adverse birth outcomes.
既往关于银屑病孕妇妊娠结局的研究，或者使用了选择性的医院数据，或者分析了产科而非婴儿特异性结局。
我们旨在利用一个未选择的全国基于人群的数据库，调查与无银屑病的母亲相比，母体银屑病是否与不良妊娠结局风险增加相关。
共纳入 1463 例银屑病母亲和 11704 例随机选择的无银屑病母亲。在 1463 例银屑病母亲中，有 645 例（44.1%）在其指数分娩前 2 年内接受过光化学疗法或系统治疗，将其纳入重度银屑病组。在调整母亲、父亲和婴儿的特征后，采用条件逻辑回归分析计算这两组的低出生体重（LBW）、早产、剖宫产、小于胎龄儿、子痫前期或子痫的风险。
调整母亲、父亲和婴儿的特征后，重度银屑病女性发生 LBW 的比值比为 1.40（95%置信区间为 1.04-1.89）。然而，轻度银屑病母亲发生 LBW、早产、剖宫产、小于胎龄儿和子痫前期或子痫的风险与无银屑病母亲相比，并无显著增加。
数据库中通过诊断代码识别银屑病患者，存在可能的分类偏倚。此外，缺乏有关母体风险行为和既往不良妊娠结局的信息，可能存在残留混杂。
我们发现重度银屑病孕妇发生 LBW 婴儿的风险增加，而轻度银屑病与不良出生结局的风险增加无关。
