David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Department of Medicine, Division of Dermatology, University of California Los Angeles, Los Angeles, California, USA.
Dermatology. 2022;238(2):260-266. doi: 10.1159/000517283. Epub 2021 Aug 17.
Hormones are thought to play a role in hidradenitis suppurativa (HS). However, data on the HS disease course during pregnancy and the postpartum period has not been well established. The objective of this study is to analyze the available literature to determine HS disease activity during pregnancy and the postpartum period.
The PubMed and Embase databases were systematically searched for relevant articles from database inception until November 22, 2020. The inclusion criteria were a study population with the diagnosis of HS and discussion of pregnancy impact on the HS disease course or postpartum flare. Study characteristics, patient demographics, HS severity, and HS disease course during pregnancy and the postpartum period were extracted by 2 independent reviewers. The quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies. Heterogeneity was assessed using Cochran's Q statistic and I2 index. The random-effects meta-analytical model was used. The primary study outcome was the pooled odds ratio of improvement or of worsening of HS disease activity during pregnancy.
The systematic search identified 8 studies for analysis. There was a total of 672 cases for which data on the patient-reported HS disease course during pregnancy were available, and 164 cases for which data on patient-reported postpartum flare were available. In the meta-analyses, the rate of HS disease improvement was 24% (95% CI 0.13-0.40) and the rate of HS disease worsening was 20% (95% CI 0.11-0.34). Sixty percent (99/164) of patients experienced a postpartum flare.
While about a quarter of women will experience an improvement in HS during pregnancy, the majority will have a stable or worsened disease course, and over half of patients will experience a postpartum flare. Close monitoring of HS patients is needed during pregnancy and postpartum periods, as patients may need continued, or even escalated, disease management.
激素被认为在化脓性汗腺炎（HS）中起作用。然而，关于怀孕期间和产后 HS 疾病过程的数据尚未得到很好的确定。本研究的目的是分析现有文献，以确定怀孕期间和产后 HS 的疾病活动。
系统地检索了 PubMed 和 Embase 数据库，以获取从数据库成立到 2020 年 11 月 22 日的相关文章。纳入标准为诊断为 HS 的研究人群，并讨论了妊娠对 HS 疾病过程或产后发作的影响。由 2 位独立评审员提取研究特征、患者人口统计学、HS 严重程度以及怀孕期间和产后的 HS 疾病过程。使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）评估纳入研究的质量。使用 Cochran's Q 统计量和 I2 指数评估异质性。使用随机效应荟萃分析模型。主要研究结果是汇总了怀孕期间 HS 疾病活动改善或恶化的优势比。
系统搜索确定了 8 项研究进行分析。共有 672 例患者的数据可用于分析怀孕期间患者报告的 HS 疾病过程，164 例患者的数据可用于分析产后发作。荟萃分析中，HS 疾病改善的发生率为 24%（95%CI 0.13-0.40），HS 疾病恶化的发生率为 20%（95%CI 0.11-0.34）。60%（99/164）的患者发生了产后发作。
虽然大约四分之一的女性在怀孕期间会出现 HS 改善，但大多数患者的疾病过程稳定或恶化，超过一半的患者会出现产后发作。HS 患者在怀孕期间和产后期间需要密切监测，因为患者可能需要继续甚至加强疾病管理。
