Cargando…

Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

IMPORTANCE: Prospective data are limited on pregnancy outcomes among women with psoriasis who may be receiving biologic or conventional systemic therapy. OBJECTIVE: To report pregnancy outcomes observed in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). DESIGN, SETTING, AND PARTICIPANTS...

Descripción completa

Detalles Bibliográficos
Autores principales: Kimball, Alexa B., Guenther, Lyn, Kalia, Sunil, de Jong, Elke M. G. J., Lafferty, Kimberly Parnell, Chen, Dan Y., Langholff, Wayne, Shear, Neil H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859871/
https://www.ncbi.nlm.nih.gov/pubmed/33533924
http://dx.doi.org/10.1001/jamadermatol.2020.5595
_version_ 1783646827009015808
author Kimball, Alexa B.
Guenther, Lyn
Kalia, Sunil
de Jong, Elke M. G. J.
Lafferty, Kimberly Parnell
Chen, Dan Y.
Langholff, Wayne
Shear, Neil H.
author_facet Kimball, Alexa B.
Guenther, Lyn
Kalia, Sunil
de Jong, Elke M. G. J.
Lafferty, Kimberly Parnell
Chen, Dan Y.
Langholff, Wayne
Shear, Neil H.
author_sort Kimball, Alexa B.
collection PubMed
description IMPORTANCE: Prospective data are limited on pregnancy outcomes among women with psoriasis who may be receiving biologic or conventional systemic therapy. OBJECTIVE: To report pregnancy outcomes observed in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from PSOLAR, a multicenter, disease-based, observational registry evaluating long-term safety and clinical outcomes for patients receiving or eligible to receive treatment for psoriasis with biologics and/or conventional systemic therapies. Of 12 090 enrollees, 5456 were women (45.1%), and 2224 women were of childbearing age (18-45 years). Participants had a total of 12 929 patient-years of follow-up (median, 7.2 [range, 3.3-8.0] years per patient). Data were collected from June 20, 2007, to August 23, 2019, and analyzed from April 23 to June 23, 2020. EXPOSURES: Exposure to biologics within the prenatal period (≤1 year before birth or ≤6 months before spontaneous abortion) or at any other time. MAIN OUTCOMES AND MEASURES: Descriptive summaries of pregnancies and pregnancy-related outcomes were self-reported in PSOLAR, including births, stillbirths, spontaneous abortions, and elective terminations. Live birth characteristics collected in PSOLAR include whether a birth was full-term (≥37 weeks) or premature (<37 weeks) and whether neonatal adverse events or congenital anomalies occurred. RESULTS: A total of 298 pregnancies occurred among 220 women (mean [SD] age, 27.8 [5.2] years), and the general fertility rate was 18.9 per 1000 women aged 18 to 45 years. Of the 298 pregnancies, 244 (81.9%) resulted in birth, 41 (13.8%) ended in spontaneous abortion, and 13 (4.4%) were electively terminated. Gestational age was available for 243 births; 221 infants (90.9%) were full-term, and 22 (9.1%) were born prematurely. Birth outcomes included 231 healthy newborns, 10 infants with a neonatal problem, 2 infants with a congenital anomaly, and 1 stillbirth. Of the 298 pregnancies, 252 were associated with biologic exposure before or during pregnancy. Pregnancy outcomes for women exposed to biologics were similar to those for women exposed to nonbiologics. Among women who became pregnant, mean (SD) age at the time of pregnancy outcome was 30.9 (4.8) years; at enrollment into the registry, 74 of 219 (33.8%) had obesity, and 121 of 220 (55.0%) were past or current smokers. CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that pregnancy outcomes in PSOLAR have remained consistent with previous reports. Overall and live birth outcomes were similar to those for the general population.
format Online
Article
Text
id pubmed-7859871
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher American Medical Association
record_format MEDLINE/PubMed
spelling pubmed-78598712021-02-11 Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR) Kimball, Alexa B. Guenther, Lyn Kalia, Sunil de Jong, Elke M. G. J. Lafferty, Kimberly Parnell Chen, Dan Y. Langholff, Wayne Shear, Neil H. JAMA Dermatol Original Investigation IMPORTANCE: Prospective data are limited on pregnancy outcomes among women with psoriasis who may be receiving biologic or conventional systemic therapy. OBJECTIVE: To report pregnancy outcomes observed in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from PSOLAR, a multicenter, disease-based, observational registry evaluating long-term safety and clinical outcomes for patients receiving or eligible to receive treatment for psoriasis with biologics and/or conventional systemic therapies. Of 12 090 enrollees, 5456 were women (45.1%), and 2224 women were of childbearing age (18-45 years). Participants had a total of 12 929 patient-years of follow-up (median, 7.2 [range, 3.3-8.0] years per patient). Data were collected from June 20, 2007, to August 23, 2019, and analyzed from April 23 to June 23, 2020. EXPOSURES: Exposure to biologics within the prenatal period (≤1 year before birth or ≤6 months before spontaneous abortion) or at any other time. MAIN OUTCOMES AND MEASURES: Descriptive summaries of pregnancies and pregnancy-related outcomes were self-reported in PSOLAR, including births, stillbirths, spontaneous abortions, and elective terminations. Live birth characteristics collected in PSOLAR include whether a birth was full-term (≥37 weeks) or premature (<37 weeks) and whether neonatal adverse events or congenital anomalies occurred. RESULTS: A total of 298 pregnancies occurred among 220 women (mean [SD] age, 27.8 [5.2] years), and the general fertility rate was 18.9 per 1000 women aged 18 to 45 years. Of the 298 pregnancies, 244 (81.9%) resulted in birth, 41 (13.8%) ended in spontaneous abortion, and 13 (4.4%) were electively terminated. Gestational age was available for 243 births; 221 infants (90.9%) were full-term, and 22 (9.1%) were born prematurely. Birth outcomes included 231 healthy newborns, 10 infants with a neonatal problem, 2 infants with a congenital anomaly, and 1 stillbirth. Of the 298 pregnancies, 252 were associated with biologic exposure before or during pregnancy. Pregnancy outcomes for women exposed to biologics were similar to those for women exposed to nonbiologics. Among women who became pregnant, mean (SD) age at the time of pregnancy outcome was 30.9 (4.8) years; at enrollment into the registry, 74 of 219 (33.8%) had obesity, and 121 of 220 (55.0%) were past or current smokers. CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that pregnancy outcomes in PSOLAR have remained consistent with previous reports. Overall and live birth outcomes were similar to those for the general population. American Medical Association 2021-02-03 2021-03 /pmc/articles/PMC7859871/ /pubmed/33533924 http://dx.doi.org/10.1001/jamadermatol.2020.5595 Text en Copyright 2021 Kimball AB et al. JAMA Dermatology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the CC-BY-NC-ND License.
spellingShingle Original Investigation
Kimball, Alexa B.
Guenther, Lyn
Kalia, Sunil
de Jong, Elke M. G. J.
Lafferty, Kimberly Parnell
Chen, Dan Y.
Langholff, Wayne
Shear, Neil H.
Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)
title Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)
title_full Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)
title_fullStr Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)
title_full_unstemmed Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)
title_short Pregnancy Outcomes in Women With Moderate-to-Severe Psoriasis From the Psoriasis Longitudinal Assessment and Registry (PSOLAR)
title_sort pregnancy outcomes in women with moderate-to-severe psoriasis from the psoriasis longitudinal assessment and registry (psolar)
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859871/
https://www.ncbi.nlm.nih.gov/pubmed/33533924
http://dx.doi.org/10.1001/jamadermatol.2020.5595
work_keys_str_mv AT kimballalexab pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT guentherlyn pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT kaliasunil pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT dejongelkemgj pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT laffertykimberlyparnell pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT chendany pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT langholffwayne pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar
AT shearneilh pregnancyoutcomesinwomenwithmoderatetoseverepsoriasisfromthepsoriasislongitudinalassessmentandregistrypsolar