Treatment for Atopic Dermatitis Generally Decreases During Pregnancy

pregnant woman using cream
pregnant woman using cream
Generally, women with AD decreased dermatologic therapy during pregnancy.

Women with atopic dermatitis (AD) typically control their disease with topical corticosteroids and ultraviolet therapy during pregnancy, according to a Danish study recently published in the Journal of the European Academy of Dermatology and Venereology.

Prior to this study, there was no information about the risk of prenatal and birth complications in mothers with a history of AD. Investigators wished to assess the relationships between prenatal, obstetric, and birth complications in mothers with AD and better understand their dermatologic care during pregnancy. To do so, they performed a retrospective matched cohort study.

Investigators identified all mother-child pairs in the Danish Medical Birth Registry between 1997 and 2014 in which the mother had a previous diagnosis of AD (International Classification of Diseases (ICD)-8 691, ICD-10 L20) in the Danish National Patient Registry prior to the birth of the child (n=10,668). Of these pairs, 10,441 (97.9%) were successfully matched by birth year, parity, and maternal age at conception with control pairs in a 1:10 ratio. 

Investigators found that women with a hospital and/or ambulatory contact for AD during pregnancy increased use of topical corticosteroid and ultraviolet therapy vs past AD therapy. Generally, however, women with AD decreased dermatologic therapy during pregnancy.

Adjusted analysis revealed that maternal AD was inversely related to gestational diabetes (odds ratio [OR] 0.79; 95% CI, 0.68-0.92), positively related to premature rupture of membranes (OR 1.15; 95% CI, 1.05-1.27), and positively related to staphylococcal neonatal septicemia (OR 2.45; 95% CI, 1.33-4.49), although the last was uncommon. However, in subanalyses with body mass index information, these relationships did not meet statistical significance.

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The researchers concluded that “[w]omen with AD during pregnancy mainly used topical corticosteroids and ultraviolet therapy to control their disease. While premature rupture of membranes and staphylococcal neonatal septicaemia were over-represented in maternal AD, no associations were found with any other significant prenatal, obstetric or birth outcome.”

Disclosure: Numerous authors note affiliations with pharmaceutical companies. Please see the referece for a complete list.

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Hamann CR, Egeberg A, Wollenberg A, Gislason G, Skov L, Thyssen JP. Pregnancy complications, treatment characteristics and birth outcomes in women with atopic dermatitis in Denmark [published online September 22, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.15256