Pregnant Women With HS at Increased Risk of Adverse Outcomes

According to a study published in the Journal of the American Academy of Dermatology, hidradenitis suppurativa (HS) may be an independent risk factor for adverse pregnancy and maternal outcomes.

HS disproportionately affects women of childbearing age, but it is not known how HS impacts pregnancy and maternal outcomes. Laura Fitzpatrick and colleagues at the Emory University School of Medicine carried out a retrospective cohort analysis using data from more than 1800 pregnancies of women with HS and 64,218 pregnancies of women without HS from January 1, 2011, to September 30, 2015. This study aimed to compare pregnancy risks between women with and without HS and evaluate the impact of comorbid conditions on treatment outcomes. The median age of pregnant women included in the study was 28 years.

The researchers found that, compared with control pregnancies, pregnant women with HS had a significantly higher risk of spontaneous abortion (37% increase), preterm birth (25% increase), gestational diabetes mellitus (59% increase), gestational hypertension (38% increase), preeclampsia (57% increase), and cesarean section (19% increase). In addition, after adjusting the model for comorbidities known to negatively affect pregnancy, such as smoking, obesity, diabetes, high blood pressure, and drug use, the researchers discovered that HS pregnancies were independently associated with spontaneous abortion, gestational diabetes, and cesarean section.

Furthermore, the researchers found an increased rate of women with HS with ectopic/molar pregnancy compared with women without HS when adjusting for age and race.

According to the authors, although this study may suggest associations between HS and pregnancy outcomes, it cannot determine whether HS actually causes those outcomes. Nevertheless, early recognition and treatment of underlying medical problems may improve the well-being of women with HS and their babies.

“Pregnant women with HS are at increased risk for adverse pregnancy and maternal outcomes. Early management strategies for comorbidities, particularly those that are modifiable, may mitigate some of these adverse outcomes,” the authors concluded. “These observations may guide dermatologists, obstetricians, and maternal-fetal medicine specialists in counseling women with HS who are seeking to conceive and in otherwise managing and closely monitoring those who are pregnant.”