Obstetrics & Gynecology, Jewish General Hospital, McGill University, Montreal, Canada.
Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, Canada.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9178-9185. doi: 10.1080/14767058.2021.2020238. Epub 2021 Dec 27.
Psoriasis is a common auto-immune disease affecting the skin and joints for which the current literature remains limited and contradictory in the context of pregnancy. The purpose of our study was to evaluate the association between psoriasis in pregnancy and maternal and newborn outcomes.
A population based retrospective cohort study was conducted using the 1999-2015 United States' Healthcare Cost and Utilization Project Nationwide Inpatient Sample. ICD-9 codes were used to identify delivery admissions to women with or without psoriasis, as well as maternal and fetal outcomes. Adjusting for baseline characteristics, multivariate logistic regression models were performed to estimate the effects of psoriasis on maternal and newborn outcomes.
The cohort consisted of 3737 women with psoriasis, among a total of 13,792,544 pregnancy admissions in US hospitals between the years 1999 and 2015, for a period prevalence of 27.1 cases per 100,000 pregnant women. Psoriasis was associated with preeclampsia, OR 1.4 (95% CI 1.2-1.6), gestational diabetes, 1.27 (1.13-1.42), myocardial infarction, 13.4 (3.3-54.6), chorioamnionitis, 1.3 (1.0-1.6), delivery by cesarean section, 1.2 (1.1-1.3), anemia, 1.74 (1.18-2.57), and requiring blood transfusions, 1.4 (1.0-1.8). Their newborns were at higher risk of being born preterm, 1.2 (1.1-1.4), congenital anomalies, 1.7 (1.2-2.4), and intra-uterine growth restriction, 1.5 (1.2-1.7).
Women with psoriasis and their newborns appear more prone to adverse outcomes of pregnancy. It would be prudent for these women to be followed closely during pregnancy by their obstetrical caregiver and dermatologist. Further investigation is warranted regarding the management of psoriasis during pregnancy.
银屑病是一种常见的自身免疫性疾病，影响皮肤和关节，目前的文献在妊娠方面仍然有限且存在矛盾。我们的研究目的是评估银屑病与妊娠期间母婴结局的关系。
采用 1999 年至 2015 年美国医疗保健成本和利用项目全国住院患者样本进行基于人群的回顾性队列研究。使用 ICD-9 编码来识别患有或未患有银屑病的女性分娩入院情况以及母婴结局。通过调整基线特征，使用多变量逻辑回归模型来估计银屑病对母婴结局的影响。
该队列包括 3737 名患有银屑病的女性，在 1999 年至 2015 年期间，美国医院共有 13792544 例妊娠分娩，期间患病率为每 100000 名孕妇中有 27.1 例。银屑病与子痫前期相关，比值比为 1.4（95%置信区间为 1.2-1.6）、妊娠糖尿病为 1.27（1.13-1.42）、心肌梗死为 13.4（3.3-54.6）、绒毛膜羊膜炎为 1.3（1.0-1.6）、剖宫产为 1.2（1.1-1.3）、贫血为 1.74（1.18-2.57）和需要输血为 1.4（1.0-1.8）。她们的新生儿早产风险更高，比值比为 1.2（1.1-1.4）、先天性畸形为 1.7（1.2-2.4）和宫内生长受限为 1.5（1.2-1.7）。
患有银屑病的女性及其新生儿似乎更容易出现妊娠不良结局。这些女性在妊娠期间由产科护理人员和皮肤科医生密切随访是谨慎的。需要进一步研究在妊娠期间管理银屑病的方法。
