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Risques psoriasis grossesse.

Psoriasis and Pregnancy: Are there any risks?

Having psoriasis can raise questions for women who wish to have children. Indeed, it is legitimate to wonder about the impacts of psoriasis on pregnancy, and vice versa. Let's clarify this together in this article.

Summary
Published February 20, 2024, by Manon, Scientific Editor — 4 min read

What is the impact of pregnancy on psoriasis?

A study analyzed the data from 91 pregnancies in women suffering from psoriasis. The results showed an improvement in 56% of cases, a worsening in 26.4%, and no change in 17.6% of situations. Women who experienced an improvement during their first pregnancy reported a similar response in subsequent pregnancies. Additionally, the body surface area affected by psoriasis significantly decreased between 10 and 20 weeks of gestation. Furthermore, an increase in symptoms after childbirth, associated with a rapid drop in levels of estrogen and progesterone, was observed in 87.7% of patients, primarily within the 4 months following birth.

The improvement of psoriasis during pregnancy appears to be linked to high levels of estrogen. However, other researchers have suggested that this improvement may be related to high levels of progesterone, which could potentially moderate the response of T lymphocytes and have a direct impact on the proliferation of keratinocytes. Indeed, another study has shown that progesterone is the pregnancy hormone with the highest immunomodulatory effect. It would inhibit the activation of T lymphocytes by plant lectins and block the response of T lymphocytes in the lymphocyte reaction.

Based on the available results in scientific literature, pregnancy appears to impact psoriasis differently, with a majority of cases showing improvement. Therefore, it is challenging to conclude a definitive effect, and additional studies need to be conducted.

What is the impact of psoriasis on the course of pregnancy?

It is essential to know that psoriasis itself is neither a contraindication nor a hindrance to pregnancy. It is important to be cautious if you suffer from psoriatic arthritis, a form of joint damage associated with psoriasis. In this situation, weight gain during pregnancy could exacerbate joint pain.

A cohort study of women suffering from psoriasis and other inflammatory skin diseases showed little effect of psoriasis on the incidence or outcome of pregnancy. Another study analyzed the entire dataset of the Danish national birth cohort, which included 2,553 pregnancies in women with psoriasis, and found no increased risk of fetal death or prolonged pregnancy. In cases of severe psoriasis, it was observed that some of these women gave birth to babies with low birth weight. However, these results may also be associated with other health issues such as hypertension or obesity.

Therefore, psoriasis does not pose a hindrance to pregnancy. Each pregnancy is unique, and although the effects of psoriasis are not known to be unfavorable, it remains difficult to assert with certainty. For cases of severe and widespread psoriasis, treatment can be complex due to the contraindications associated with certain medical treatments. It is therefore important to consult with a qualified healthcare professional to receive care tailored to your specific situation. It is always preferable to seek recent information from healthcare professionals to properly manage psoriasis during pregnancy.

Sources

  • BOYD A. S. & al. Psoriasis and pregnancy : Hormone and immune system interaction. International Journal of Dermatology (1996).

  • LIMA X. T. & al. The impact of psoriasis on pregnancy outcomes. Journal of Investigative Dermatology (2012).

  • VENA G. A. & al. Psoriasis in pregnancy: challenges and solutions. Psoriasis : Targets and Therapy (2015).

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