Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark.
J Eur Acad Dermatol Venereol. 2019 Mar;33(3):577-587. doi: 10.1111/jdv.15256. Epub 2018 Oct 8.
The risk of prenatal, obstetric and birth complications in mothers with atopic dermatitis (AD), along with treatment use during pregnancy, is unknown.
To examine the associations between prenatal, obstetric and birth complications in mothers with AD and describe the dermatologic care received during pregnancy.
Mother-child pairs, in which the mother had a history of AD, were identified through the Danish Medical Birth Registry and matched 1 : 10 with non-AD pairs. Data on dermatologic treatment and prenatal, obstetric and birth complications were obtained through linkage via nationwide registers. Multiple logistic regression was performed.
We identified 10 668 births from 1997 through 2014 to women with AD. Women with a hospital/ambulatory contact for AD during pregnancy had increased topical corticosteroid and ultraviolet therapy use during pregnancy compared to prior. However, overall, women with AD received decreased dermatologic therapy during pregnancy compared to prior. In adjusted analysis, maternal AD was inversely associated with gestational diabetes [OR 0.79, 95% CI (0.68-0.92)], but positively associated with premature rupture of membranes [1.15 (1.05-1.27)] and staphylococcal neonatal septicemia [2.45 (1.33-4.49)]-albeit the latter was rare. These associations did not meet statistical significance in sub-analysis where body mass index data were available. No associations were found with preeclampsia, prematurity or non-staphylococcal neonatal septicaemia.
Women with AD during pregnancy mainly used topical corticosteroids and ultraviolet therapy to control their disease. While premature rupture of membranes and staphylococcal neonatal septicaemia were over-represented in maternal AD, no associations were found with any other significant prenatal, obstetric or birth outcome.
患有特应性皮炎(AD)的母亲在产前、产科和分娩时出现并发症的风险,以及怀孕期间的治疗使用情况尚不清楚。
研究 AD 母亲的产前、产科和分娩并发症与描述怀孕期间接受的皮肤科护理之间的关联。
通过丹麦医学出生登记处确定患有 AD 病史的母婴对,并与 10 个非 AD 母婴对进行 1:10 匹配。通过全国性登记处进行链接,获取皮肤科治疗以及产前、产科和分娩并发症的数据。进行多变量逻辑回归分析。
我们在 1997 年至 2014 年期间发现了 10668 例母亲患有 AD 的分娩。在怀孕期间有医院/门诊 AD 接触史的女性在怀孕期间使用局部皮质类固醇和紫外线疗法的比例高于之前。然而,总体而言,AD 女性在怀孕期间接受的皮肤科治疗比之前减少。在调整分析中,母亲患有 AD 与妊娠期糖尿病呈负相关[比值比 0.79,95%置信区间(0.68-0.92)],但与胎膜早破呈正相关[1.15(1.05-1.27)]和葡萄球菌新生儿败血症[2.45(1.33-4.49)]相关,尽管后者较为罕见。在有体重指数数据的亚分析中,这些关联没有达到统计学意义。与子痫前期、早产或非葡萄球菌新生儿败血症均无关联。
怀孕期间患有 AD 的女性主要使用局部皮质类固醇和紫外线疗法来控制疾病。虽然胎膜早破和葡萄球菌新生儿败血症在 AD 母亲中较为常见,但与任何其他重要的产前、产科或分娩结局均无关联。