497 Pregnancy outcomes in patients with hidradenitis suppurativa

Abstract

Hidradenitis suppurativa is a debilitating inflammatory skin disease with a chronic course and often disappointing response to treatment. The purpose of this study was to evaluate the association between Hidradenitis suppurativa and pregnancy, delivery and neonatal outcomes. We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database (HCUP-NIS) from the United States. The study included women who delivered between 1999 and 2015. We evaluated obstetrical and neonatal outcomes among pregnant women with Hidradenitis suppurativa (ICD-9 code 705.83) and compared them to the obstetric population without Hidradenitis suppurativa. Multivariate logistic regression was used to compare maternal and neonatal outcomes between these two groups, while adjusting for maternal baseline confounding variables. The study included 13,792,544 pregnant women, of which 1,021 of them had a diagnosis of Hidradenitis suppurativa (7.4 per 100,000 deliveries). During the observation period there was an upward trend in the prevalence of this disease among pregnant women (<0.0001). Pregnant women with Hidradenitis suppurativa were more likely to be of African-American descent, to belong to a lower income quartile, to have Medicare insurance and were more likely 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 Hidradenitis suppurativa 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 Hidradenitis suppurativa were found to be at increased risk of congenital anomalies (OR 2.00, 95% CI 1.10-3.62). Hidradenitis suppurativa is a complex and refractory inflammatory skin disorder that often requires multidisciplinary team management in pregnancy. Pregnancies in these women were associated with increased risk of preeclampsia and increased risk of congenital anomalies.