Pregnancy outcomes in women with moderate-to-severe psoriasis

Background The association between psoriasis and pregnancy outcomes has not been adequately examined, although psoriasis onset is common in the reproductive period. Objective To evaluate the association between moderate-to-severe psoriasis and pregnancy complications. Methods A retrospective, matched cohort study of 68 deliveries in 35 women with moderate-to-severe psoriasis compared to 237 deliveries in 236 women without psoriasis randomly selected after matching for age, parity and gestational age. Results The psoriasis patients had higher mean of past spontaneous (0.42 +/- 0.58 vs. 0.26 +/- 0.63, P = 0.002) and induced (0.32 +/- 0.60 vs. 0.06 +/- 0.25, P = 0.001) abortions than controls. They had a higher percentage of pregnancy-induced hypertensive diseases (7.4% vs. 2.1%, P < 0.05) and premature rupture of membranes (16% vs. 5.5%, P < 0.008). Newborns to women with psoriasis had higher birth weight (3375 +/- 543 g vs. 3247 +/- 460 g, P = 0.03), increased percentage of large-for-gestational age (24% vs. 12%, P = 0.02), and macrosomia (13% vs. 4.2% P = 0.02). In multivariate analysis, moderate-to-severe psoriasis was an independent risk factor for previous spontaneous abortions, induced abortions, premature rupture of membranes (PROM), and newborn macrosomia. Conclusion Moderate-to-severe psoriasis is associated with spontaneous and induced abortions, pregnancy-induced hypertensive diseases, premature rupture of membranes, large-for-gestational age newborns, and macrosomia.