Department of Dermatology, A. Gemelli University Hospital and Institute for Research and Cancer, IRCCS, Sacred Heart Catholic University, Rome, Italy -
Department of Dermatology, A. Gemelli University Hospital and Institute for Research and Cancer, IRCCS, Sacred Heart Catholic University, Rome, Italy.
G Ital Dermatol Venereol. 2019 Jun;154(3):305-314. doi: 10.23736/S0392-0488.18.06255-7.
Psoriasis affects 2-4% of the world's population, with no difference between men and women and 70% of patients experiencing disease onset before the age of 40, which coincides with the reproductive years. Few data are available from literature on impact of psoriasis on fertility, course and outcome of pregnancy and risk associated with treatments. Recent studies on other immune-mediated inflammatory diseases, among which psoriasis is also included, indicate that rheumatoid arthritis and inflammatory bowel diseases can impact female fertility and pregnancy outcomes especially during active disease episodes. In psoriasis hormonal and metabolic comorbidities, unhealthy lifestyles and systemic inflammation could also influence the ability to conceive, pregnancy course and birth outcomes. In this article we review current knowledge on reproductive function, course and outcome of pregnancy in women affected by moderate-to-severe psoriasis. Systemic treatments are also considered with a special focus on TNF-alpha blocking agents and implication of molecular structure on placental transportation and fetal exposure.
银屑病影响全球 2-4%的人口，男性和女性之间无差异，70%的患者在 40 岁之前发病，这与生育年龄相吻合。关于银屑病对生育能力、妊娠过程和结局以及治疗相关风险的影响，文献中仅有少量数据。最近对其他免疫介导的炎症性疾病（其中包括银屑病）的研究表明，类风湿关节炎和炎症性肠病会影响女性的生育能力和妊娠结局，尤其是在疾病活动期。在银屑病中，激素和代谢合并症、不健康的生活方式和全身炎症也可能影响受孕能力、妊娠过程和分娩结局。本文综述了目前关于中重度银屑病女性的生殖功能、妊娠过程和结局的知识。还考虑了全身治疗，特别关注 TNF-α 阻断剂以及分子结构对胎盘转运和胎儿暴露的影响。
