Women with autoimmune conditions such as psoriasis and psoriatic arthritis are at significantly higher risk of experiencing adverse pregnancy outcomes, a large-scale review has confirmed.
It also highlighted an urgent need for more research on the potential pregnancy risks across a wider range of autoimmune disorders, as well as the development of new guidelines to help inform clinicians and patients in making personalised treatment decisions.
The umbrella review, undertaken by researchers from the Institute of Applied Health Research, University of Birmingham and published in BMC Medicine, was based on 709 primary studies investigating links between autoimmune conditions and adverse pregnancy outcomes.
Overall, the review found that an association was reported between 12 autoimmune conditions and 16 adverse pregnancy outcomes.
Psoriasis and psoriatic arthritis were linked with a 20-50% higher odds of gestational hypertension (OR 1.29 and OR 1.49, respectively), and raised risk of preterm birth (OR 1.22 and OR 1.48), but only psoriasis increased the likelihood of miscarriage (OR 1.10).
Women with systemic lupus erythematosus (SLE) had a greater risk of miscarriage (OR 4.90), pre-eclampsia (OR 3.20), having a baby small for gestational age (OR 2.49), a preterm birth (OR 2.79) and having a baby with a low birth weight (OR 5.95).
There was also a very high risk of stillbirth in women with SLE, although confidence intervals were particularly wide (OR 16.90; CI 3.02-94.40), researchers noted.