A significantly increased risk for spontaneous abortion and reduced live births has been reported among women with vitiligo in a 10-year nationwide retrospective cohort study conducted in Korea and published in the Journal of the American Academy of Dermatology.
Using the Korean National Health Insurance Claims database between January 1, 2007, and December 31, 2016, the investigators examined a total of 4738 first-time pregnancies in women with vitiligo and 47,380 pregnancies in age-matched controls without the disorder.
In both groups of women, the peak age at pregnancy was 21 to 30 years (50.8% of participants), which was followed by 31 to 40 years (42.0% of participants). Among the women with vitiligo, 85.2% (4038 of 4738) had limited lesions and 14.8% (700 of 4738) had extensive disease involvement.
Multivariate logistic regression models were used to assess the links between vitiligo and pregnancy outcomes, including live births, cesarean delivery, preterm delivery, gestational diabetes, spontaneous abortions, stillbirth, preeclampsia/eclampsia, and intrauterine growth retardation.
Patients with vitiligo demonstrated a significantly lower birth rate (odds ratio [OR] 0.870; 95% CI, 0.816-0.927). In subgroup analysis based on extent of disease, live birth rates were lower both in patients with limited disease (OR 0.877; 95% CI, 0.819-0.940) and in those with extensive disease (OR 0.828; 95% CI, 0.708-0.970).
A significantly higher incidence of spontaneous abortion was reported among pregnant women with vitiligo compared with pregnant women without the condition (14.7% vs 12.1%;OR 1.250; 95% CI, 1.148-1.362). Subgroup analysis showed the spontaneous abortion rate to be significantly higher both in patients with limited disease (OR 1.245; 95% CI, 1.136-1.364) and in those with extensive disease (OR 1.282; 95% CI, 1.040-1.580).
The investigators concluded that additional research is warranted to determine whether systemic autoimmunity may help explain these findings in this population of patients, as systemic autoimmunity can affect the progress of a pregnancy, causing maternal complications and adverse fetal outcomes.
Park KY, Kwon HJ, Wie JH, et al. Pregnancy outcomes in patients with vitiligo: a nationwide population-based cohort study from Korea [published online February 22, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.02.036