A recent study has found that maternal hidradenitis suppurativa (HS), a chronic inflammatory skin condition, is associated with a higher risk of pregnancy complications and adverse health outcomes for both mothers and their children.
The research, which analyzed data from over 1 million deliveries in Quebec, Canada, revealed that pregnant individuals with HS face an increased risk of hypertensive disorders, gestational diabetes, and other delivery-related complications. Neonates born to mothers with HS were also more likely to experience preterm birth and congenital birth defects. Even after delivery, the study suggests that mothers and their children remain at elevated risk for a range of morbidities, underscoring the long-term impact of the condition.
HS is characterized by painful, inflamed lesions that can lead to scarring, drainage, and malodor. These symptoms often cause significant physical discomfort and have been linked to negative psychosocial effects, including depression and anxiety. The condition primarily affects women, with most cases appearing between the ages of 21 and 29.
Although HS disproportionately affects individuals of reproductive age, its specific impact on pregnancy and offspring health has been poorly understood. “Few studies have examined the effect of HS on maternal and offspring outcomes,” said Kaiyang Li, BSc, a medical student at McGill University, and colleagues in their study. To fill this gap, they conducted a population-based, longitudinal cohort study using hospital delivery data from Quebec.
The study, which examined births from April 2006 to March 2022, used the Maintenance and Use of Data for the Study of Hospital Clientele registry. This database includes discharge records for nearly all births in Quebec, providing a comprehensive source of data for the research. The study included 1,324,488 deliveries, with 1,332 (0.1%) involving mothers diagnosed with HS, as identified through ICD-10 codes.
Researchers categorized outcomes into four groups: maternal pregnancy outcomes, neonatal outcomes at birth, maternal health outcomes up to 16 years post-delivery, and child health outcomes up to 16 years after birth. By analyzing diagnostic codes and procedure data, the study found that mothers with HS were significantly more likely to be younger (under 25 years), have comorbid conditions, and experience socio-economic disadvantages compared to those without the condition.
The study found that pregnant individuals with HS were at a heightened risk for several complications, including:
- Hypertensive disorders of pregnancy (risk ratio [RR], 1.55; 95% CI, 1.29–1.87)
- Gestational diabetes (RR, 1.61; 95% CI, 1.40–1.85)
- Severe maternal morbidity (RR, 1.38; 95% CI, 1.03–1.84)
- Cesarean delivery (RR, 1.18; 95% CI, 1.07–1.30)
- Postpartum hemorrhage (RR, 1.49; 95% CI, 1.27–1.76)
- Peripartum sepsis (RR, 2.71; 95% CI, 1.30–5.67)
- ICU admission (RR, 2.64; 95% CI, 1.64–4.25)
For neonates, maternal HS was linked to an increased risk of:
- Preterm birth (RR, 1.28; 95% CI, 1.07–1.53)
- Birth defects (RR, 1.29; 95% CI, 1.07–1.56), including congenital heart defects (RR, 1.57; 95% CI, 1.01–2.43) and orofacial clefts (RR, 4.27; 95% CI, 1.84–9.92).
Long-term outcomes also revealed that mothers with HS were 2.29 times more likely to require hospitalization later in life (95% CI, 2.07–2.55), and their children had a 1.31 times higher risk of hospitalization (95% CI, 1.18–1.45). These hospitalizations were primarily due to respiratory, metabolic, psychiatric, and immune-related conditions.
The study acknowledged several limitations, including potential coding errors and the exclusion of mild cases of HS that did not require hospitalization. Additionally, as an observational study, it cannot definitively establish a causal link between HS and the observed health outcomes.
Despite these limitations, the authors concluded that the study’s findings underscore the importance of closely monitoring pregnant individuals with HS and their offspring. “Given the increased rate of adverse outcomes, clinicians should consider more intensive monitoring during pregnancy and long-term follow-up for both mothers and their children,” the study authors emphasized.
This research provides valuable insight into the broader health impacts of maternal hidradenitis suppurativa and highlights the need for further attention to this often-overlooked condition in reproductive health.
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