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Published on: October 12, 2012
Pemphigus and pregnancy: a 23-year experience
Maryam Daneshpazhooh1, Cheyda Chams-Davatchi, Mahin Valikhani
1Department of Dermatology, Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. daneshpj@turns.ac.ir
Summary
Pregnancy can affect pemphigus disease course, with exacerbations occurring in over half of patients. Careful monitoring is essential for high-risk mothers and fetuses during and after pregnancy.
Area of Science:
- Dermatology
- Obstetrics & Gynecology
- Autoimmune Diseases
Background:
- Limited research exists on pemphigus and pregnancy interactions, often confined to case reports.
- Pemphigus onset at a younger age in Iranian women increases the likelihood of pregnancy during the disease.
- Understanding pregnancy outcomes in pemphigus patients is crucial due to disease prevalence in women of reproductive age.
Purpose of the Study:
- To investigate the outcomes of pregnancy in women with pemphigus.
- To analyze the course of pemphigus disease during and after pregnancy.
Main Methods:
- Retrospective study analyzing 779 pemphigus women under 50 (1984-2006).
- Data collection focused on pregnancy history, outcomes, and pemphigus disease activity.
- Identified 66 patients with a history of pregnancy, including 48 with pre-existing pemphigus.
Main Results:
- Pemphigus exacerbation occurred in 54% of pregnancies in known pemphigus patients; 17% showed improvement.
- The abortion rate was 9.6% (5 cases), and 11% of pregnancies where pemphigus began during gestation resulted in abortion.
- Postpartum pemphigus flare was observed in 47.1% of cases.
Conclusions:
- Pregnancy can lead to pemphigus exacerbations, though often mild, with a considerable abortion rate.
- While stillbirth rates were lower than previously suggested, careful maternal and fetal monitoring is mandatory.
- Pregnancy can be uneventful, particularly in patients with pemphigus in clinical remission.
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