Department of Dermatology, Chung Ang University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Am Acad Dermatol. 2018 Nov;79(5):836-842. doi: 10.1016/j.jaad.2018.02.036. Epub 2018 Mar 1.
Vitiligo is a chronic autoimmune skin disorder affecting 1% of populations worldwide. Few large-scale studies have explored adverse pregnancy outcomes in patients with vitiligo.
To investigate adverse pregnancy outcomes in patients with vitiligo.
We performed a retrospective cohort study on 4738 pregnancies of women with vitiligo and 47,380 pregnancies of age-matched controls without vitiligo using the Korean National Health Insurance Claims database from 2007 to 2016. Multivariate logistic regression models were used to evaluate the associations between vitiligo and pregnancy outcomes, including live births, spontaneous abortion, cesarean delivery, preterm delivery, gestational diabetes mellitus, stillbirth, pre-eclampsia/eclampsia, and intrauterine growth retardation.
Patients with vitiligo exhibited a significantly lower live birth rate (odds ratio, 0.870; 95% confidence interval, 0.816-0.927) and a higher incidence of spontaneous abortion (odds ratio, 1.250; 95% confidence interval, 1.148-1.362) than the control group.
The Korean National Health Insurance Claims database lacks detailed clinical information on individual patients.
Vitiligo was significantly associated with an increased risk of spontaneous abortion. Further studies are needed to determine whether systemic autoimmunity explains our finding.
白癜风是一种影响全球 1%人口的慢性自身免疫性皮肤疾病。很少有大规模研究探讨过白癜风患者的不良妊娠结局。
探讨白癜风患者的不良妊娠结局。
我们使用韩国国家健康保险索赔数据库，对 2007 年至 2016 年间 4738 例白癜风女性患者和 47380 例年龄匹配的无白癜风对照者的 4738 例妊娠进行了回顾性队列研究。采用多变量逻辑回归模型评估白癜风与妊娠结局（包括活产、自然流产、剖宫产、早产、妊娠期糖尿病、死胎、子痫前期/子痫和宫内生长迟缓）之间的关系。
与对照组相比，白癜风患者的活产率显著降低（比值比，0.870；95%置信区间，0.816-0.927），自然流产发生率更高（比值比，1.250；95%置信区间，1.148-1.362）。
韩国国家健康保险索赔数据库缺乏个体患者的详细临床信息。
白癜风与自然流产风险增加显著相关。需要进一步研究以确定系统性自身免疫是否可以解释我们的发现。
