Psoriasis Tied to Higher Cardiovascular Risk in Delivery

TOPLINE:

Pregnant women with psoriasis experienced significantly higher rates of preeclampsia/eclampsia and cardiac arrhythmias during delivery than women without psoriasis, in a study of a nationally representative sample of women in the United States.

METHODOLOGY:

• Researchers utilized the National Inpatient Sample database to identify 37,482,206 women aged 18 years or older hospitalized for delivery from 2011 to 2020, of which 23,588 patients had psoriasis.
• Compared with delivery hospitalization in patients without psoriasis, those with psoriasis were slightly older (30.8 ± 5.5 years vs 28.8 ± years), were more likely to have multiple gestations (2.4% vs 2%), had a history of smoking (13% vs 5.3%), and were less likely to have a cesarean delivery (39% vs 47.2%). Most patients were White (about 67% of those with psoriasis vs nearly 50% of those without psoriasis).
• Women with psoriasis had a higher prevalence of prepregnancy comorbidities, including hypertension (1% vs 0.4%), diabetes mellitus (3.0% vs 1.1%), hyperlipidemia (1% vs 0.2%), obesity (18.7% vs 8.9%), chronic kidney disease (0.4% vs 0.09%), and coronary artery disease (0.1% vs 0.03%).
• Propensity score matching was performed in 4735 patients with psoriasis and 14,205 matched patients without psoriasis. The study outcome was pregnancy complications at delivery.

TAKEAWAY:

• Trends indicate that hospitalizations for delivery among patients with psoriasis increased from 2011 to 2015, then declined in 2016 before rising again in 2020.
• Pregnant patients with psoriasis had higher rates of preeclampsia/eclampsia (5.5% vs 3.5%; P P = .002), cardiac arrhythmias (1.4% vs 0.8%; P P
• In a propensity-matched analysis, psoriasis was significantly associated with increased risk for preeclampsia/eclampsia (odds ratio [OR], 1.25; 95% CI, 1.08-1.43; P = .002) and cardiac arrhythmias (OR, 1.44; 95% CI, 1.08-1.93; P = .01).
• Patients with psoriatic arthritis (PsA) had a higher risk for acute kidney injury (adjusted OR, 5.36; 95% CI, 1.25-22.88; P = .023). Because of the low number of women with PsA (4467), associations with other maternal outcomes could not be determined.

IN PRACTICE:

“These findings highlight the need to ensure cardiovascular screening, prevention of comorbidities, and being watchful for a wide range of cardiovascular complications during delivery and the peripartum period, especially given the rising trend of delivery hospitalizations in this patient population in the last decade,” the authors wrote.

SOURCE:

The study was led by Ankit Agrawal, MD, Department of Cardiovascular Medicine, at the Cleveland Clinic, Cleveland. It was published online on January 20 in JACC: Advances.

LIMITATIONS:

Information on disease diagnosis, severity, and treatment was not available. Other limitations included possible overestimation bias, lack of laboratory values, and medication history. A low number of events for peripartum cardiomyopathy, acute coronary syndrome, and stroke limited the ability to assess associations for these conditions.

DISCLOSURES:

The authors did not report any funding source. Three authors reported being on advisory boards and/or receiving consulting fees and grants from pharmaceutical companies and/or other sources. Other authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.