Pregnant patients with hidradenitis suppurativa face up to 60% higher risks of complications like gestational diabetes and hypertensive disorders, according to a recent study with up to 16 years of follow-up.

The population-based cohort study conducted in Quebec, Canada, assessed the association between hidradenitis suppurativa (HS) and adverse maternal and offspring outcomes. The study included 1,324,488 deliveries between 2006 and 2022, of which 1,332 (0.1%) involved mothers diagnosed with HS.

Key findings, published in JAMA Dermatology, indicated that HS was associated with increased risks of pregnancy complications. Mothers with HS experienced a 55% higher risk of hypertensive disorders during pregnancy (RR, 1.55; 95% CI, 1.29-1.87), a 61% higher risk of gestational diabetes (risk ratio [RR], 1.61; 95% confidence interval [CI], 1.40-1.85), and a 38% increased risk of severe maternal morbidity (RR, 1.38; 95% CI, 1.03-1.84). HS was also associated with an increased risk of cesarean delivery (RR, 1.18 [95% CI, 1.07-1.30]).

Neonates born to mothers with HS were found to have a 28% higher risk of preterm birth (RR, 1.28; 95% CI, 1.07-1.53) and a 29% higher risk of birth defects (RR, 1.29; 95% CI, 1.07-1.56). Notably, there were increased risks for congenital heart defects (RR, 1.57 [95% CI, 1.01-2.43]) and orofacial clefts (RR, 4.27 [95% CI, 1.84-9.92]).

In the long term, mothers with HS had 2.29 times the risk of hospitalization (95% CI, 2.07-2.55) compared to those without HS, with elevated risks for metabolic (hazard ratio [HR], 5.05), respiratory (HR, 3.20), and cardiovascular (HR, 3.09) conditions. HS was also strongly associated with infection (HR, 3.37 [95% CI, 2.86-3.99]) and allergy hospitalization (RR, 4.02 [95% CI, 2.62-6.17]).

Children born to mothers with HS were also at increased risk of hospitalization, with a 31% higher overall risk (RR, 1.31; 95% CI, 1.18-1.45), including 2.64 times the risk of metabolic hospitalization (95% CI, 1.58-4.41) and increased risks for developmental disorders.

The study adjusted for various factors including maternal age, parity, multiple birth, comorbidity, socioeconomic deprivation, and year of delivery. However, limitations include potential misclassification and a focus on severe cases requiring hospitalization.

The cohort study demonstrated an association between HS and negative outcomes for both mothers and their offspring during the peripartum period, as well as over the long term. The findings suggest that addressing HS early in pregnancy could potentially reduce these risks.

Full disclosures can be found in the published study.