In Spain, women with moderate to severe psoriasis tend to reduce their frequency of breastfeeding over time, possibly due to worsening disease after childbirth, according to research findings published in the Journal of the European Academy of Dermatology and Venereology.
The researchers of the study explained that women with psoriasis may experience disease worsening during pregnancy as well as postpartum flares. In addition, the investigators noted that some nursing mothers with psoriasis may experience koebnerization caused by infant suckling, leading to early breastfeeding discontinuation. Another issue among women with psoriasis, the investigators added, includes patients’ concerns about the safety of medications.
In their study, researchers evaluated the effect of psoriasis on breastfeeding in 38 women with moderate to severe disease who were included in the BIOBADADERM Registry (Spain). All pregnancies registered from October 2008 to February 2021 were included in the analysis (N=72). The age of participants at first pregnancy was 30.37 years. Most of the women (68.6%) reported breastfeeding for a median duration of 5 months.
A total of 5 women received biologic agents during the lactation period, including ustekinumab (n=4), certolizumab (n=3), adalimumab (n=2), etanercept (n=2) and infliximab (n=1). Although nearly half (42.9%) of women recalled their disease being moderate to severe during pregnancy, only 11.4% of women received any systemic therapy during pregnancy.
Approximately 68.6% of women said their psoriasis worsened after childbirth, and11.9% of women presented with nipple psoriasis lesions that worsened with breastfeeding. The investigators noted that their results “indicate a greater reduction in breastfeeding than previously described in Spanish women.”
The retrospective nature of the study represented a potential study limitation.
The researchers wrote that additional “studies confirming these results are necessary in order to describe the causes of this decreased in breastfeeding in women with moderate-to-severe psoriasis and help them make important decisions, such as whether to breastfeed or not.”
Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.
Rivera-Diaz R, Llamas-Velasco M, Carretero G, et al. Women with moderate-to-severe psoriasis in Spain (BIOBADADERM registry) breastfeed less when compared with general population. J Eur Acad Dermatol Venereol. Published online October 9, 2021. doi:10.1111/jdv.17737