Maternal and neonatal outcomes in pregnant women with psoriasis and psoriatic arthritis: a systematic review and meta-analysis.
Rheumatology (Oxford)
; 60(9): 4018-4028, 2021 09 01.
Article
em En
| MEDLINE
| ID: mdl-33878171
OBJECTIVE: Psoriasis and PsA are inflammatory diseases that affect women in their reproductive years. We aimed to investigate whether maternal psoriasis and PsA are associated with adverse pregnancy outcomes. METHODS: We searched multiple electronic databases from inception to 3 August 2020, and reference lists of selected articles. Observational studies reporting at least one pregnancy outcome in women with psoriasis or PsA with a comparator of general population or healthy subjects were included. Data were pooled by random-effects models and expressed as odds ratio (OR) and 95% CI. RESULTS: Overall, 16 studies were included in the meta-analysis. The pooled analyses showed pregnant women with psoriatic diseases have a significantly higher risk of adverse maternal outcomes compared with the general population [caesarean delivery: 1.33 (1.17, 1.52); preterm birth: 1.32 (1.15, 1.52); (pre)eclampsia: 1.28 (1.14, 1.43); gestational diabetes: 1.19 (1.10, 1.30); gestational hypertension: 1.30 (1.18, 1.44)]. However, no statistically increased risks of fetal complications were observed in women with psoriatic diseases [small for gestational age: 1.02 (0.93, 1.11); low birth weight: 1.15 (0.93, 1.42); congenital malformations: 1.03 (0.93, 1.14); Apgar score <7: 1.07 (0.81, 1.39); neonatal mortality: 1.13 (0.90, 1.43); stillbirth: 1.19 (0.95, 1.50)]. Subgroup analysis found similar results in women with either psoriasis or PsA regarding maternal outcomes, and the magnitude of risk estimates seems to be greater in PsA, though without statistical difference. CONCLUSIONS: Pregnant women with psoriasis and PsA have excess risk of adverse maternal events, but not adverse neonatal events. Close monitoring of the mothers' clinical status before and during pregnancy is decidedly required in daily practice.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
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Psoríase
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Resultado da Gravidez
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Artrite Psoriásica
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Gestantes
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Systematic_reviews
Limite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
Rheumatology (Oxford)
Assunto da revista:
REUMATOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
China