Pregnancy outcomes in patients with hidradenitis suppurativa

Abstract

Objectives Hidradenitis suppurativa (HS) is a debilitating, refractory inflammatory skin disease with a chronic course. The purpose of this study was to evaluate the association between HS and pregnancy, delivery and neonatal outcomes. Methods We conducted a retrospective cohort study using the United States’ Healthcare Cost and Utilization Project Nationwide Inpatient Sample. All women who delivered between 1999-2015 were included. We evaluated obstetrical and neonatal outcomes among pregnant women with HS (ICD-9 code 705.83) and compared them to the obstetric population without HS. Multivariate logistic regression was used to compare maternal and neonatal outcomes between these two groups, while adjusting for maternal baseline confounding variables. Results There were 13,792,544 pregnant women, of which 1,021 had a diagnosis of HS (7.4/100,000 deliveries). During the observation period, there was an upward trend in the prevalence of this disease among pregnant women. Pregnant women with HS were more likely to be African-American, to belong to a lower income quartile, to receive Medicare, and to be discharged from an urban-teaching hospital. They were also more likely to smoke, to be morbidly obese, and to be hypertensive. Women with HS had a greater likelihood of delivering by cesarean section (OR 1.7, 95% CI 1.56-2.02) and developing preeclampsia (OR 1.36, 95% CI 1.08-1.71). Neonates of mothers with HS were at increased risk of congenital anomalies (OR 2.00, 95% CI 1.10-3.62). Conclusions HS is a complex skin disorder that often requires multidisciplinary team management in pregnancy. Pregnancies in these women were associated with increased risk of preeclampsia and congenital anomalies.