A recent study of over 1 million births in Quebec has highlighted the increased risks pregnant women with hidradenitis suppurativa (HS) face, both during pregnancy and in the long term for themselves and their children. The findings underscore the need for heightened monitoring and care for expectant mothers with this chronic skin condition.
Hidradenitis suppurativa is a painful, inflammatory skin disorder that often leads to recurrent lesions, scarring, and psychosocial challenges due to its visible nature. Though it primarily affects women, particularly those between the ages of 21 and 29, its impact on maternal and fetal health had not been well documented until now.
Researchers at McGill University conducted a population-based, longitudinal cohort study to explore the relationship between maternal HS and pregnancy outcomes. Their analysis, which spanned from 2006 to 2022 and included data from over 1.3 million deliveries in Quebec, revealed several alarming risks for mothers and their newborns.
Pregnant women with HS were found to face an elevated risk of various complications, including hypertensive disorders (high blood pressure), gestational diabetes, and severe maternal morbidity. These women were also more likely to experience cesarean deliveries, postpartum hemorrhage, and peripartum sepsis. Additionally, their neonates were at a higher risk for preterm birth and birth defects, particularly congenital heart defects and orofacial clefts.
The study, which analyzed hospital discharge records from the Quebec registry, identified 1,332 births among women with HS, accounting for 0.1% of the total sample. The data revealed significant sociodemographic differences between the HS group and the general population, including younger maternal age, higher comorbidity rates, and greater socioeconomic disadvantage.
In terms of pregnancy complications, mothers with HS were found to be 55% more likely to develop hypertensive disorders and 61% more likely to develop gestational diabetes. They also had a 38% increased risk of severe maternal morbidity and were significantly more likely to require a cesarean section. Other complications such as postpartum hemorrhage, sepsis, and ICU admission were also notably more frequent in this group.
For neonates, the study found that babies born to mothers with HS had a 28% increased risk of being born prematurely and a 29% increased risk of congenital birth defects. The most common defects identified were congenital heart issues and orofacial clefts, which were found at significantly higher rates among infants of mothers with HS.
The study also tracked long-term health outcomes, revealing that mothers with HS had more than twice the risk of hospitalization later in life, particularly for conditions related to respiratory, metabolic, psychiatric, and immune disorders. Children born to mothers with HS also had a 31% higher risk of hospitalization over time.
Despite the large-scale nature of the study, the authors acknowledged several limitations, including the potential for misclassification of mild cases of HS that did not require inpatient care. Additionally, as the data was observational, no definitive conclusions about causality can be drawn.
Nevertheless, the researchers concluded that the findings point to a clear need for closer monitoring of pregnant women with HS and ongoing health surveillance for their children. “Given the increased rates of adverse outcomes associated with HS, clinicians should consider more frequent monitoring during pregnancy and long-term follow-up for offspring,” the study’s authors recommended.
This research, the first of its kind to comprehensively assess the impact of HS on pregnancy outcomes, provides critical insights for healthcare providers managing expectant mothers with this challenging condition.
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