Monday, March 30, 2026

Meta-Analysis: HS in Pregnancy Linked to Higher Odds of Gestational Diabetes, Preterm Birth, Birth Defects

Key Takeaway
Coordinate care between dermatology and obstetrics for pregnant patients with HS to monitor for and manage increased risks of gestational diabetes, pre-eclampsia, and adverse fetal outcomes.

This systematic review and meta-analysis investigated the association between maternal hidradenitis suppurativa (HS) and adverse pregnancy outcomes (APOs). The review included four retrospective cohort studies, encompassing a total of 15,189,175 pregnancies. The overall risk of bias across the included studies was assessed as low to unclear using the Newcastle-Ottawa Scale. A random-effects meta-analysis using the inverse-variance-weighted method was performed. The analysis revealed significant associations between maternal HS and several APOs. For maternal outcomes, HS was associated with increased odds of gestational diabetes mellitus (OR 1.46, 95% CI 1.09-1.96), pre-eclampsia/eclampsia (OR 1.18, 95% CI 1.01-1.38), caesarean section (OR 1.31, 95% CI 1.04-1.64), and postpartum haemorrhage (OR 1.39, 95% CI 1.07-1.82). Regarding adverse fetal outcomes, maternal HS was significantly associated with spontaneous abortion (OR 1.19, 95% CI 1.06-1.34), preterm birth (OR 1.17, 95% CI 1.04-1.31), and birth defects (OR 1.47, 95% CI 1.03-2.11). The authors conclude that pregnant women with HS have an increased risk of APOs. They underscore the need for coordinated care between dermatologists and obstetricians, as well as early diagnosis and intervention to mitigate potential risks to maternal health and fetal development.

View Original Abstract ↓
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis primarily affecting women of reproductive age. HS may contribute to an increase of adverse pregnancy outcomes (APOs). OBJECTIVES: To investigate the association of HS with APOs. METHODS: A systematic review was conducted of observational studies examining the association of maternal HS with APOs. We searched MEDLINE, Embase and CENTRAL from inception to 15 March 2025 for relevant studies. No restrictions were imposed on language or geographical regions. Observational studies, including cohort and case-control designs, which examined the odds or risk of APOs among pregnant patients were considered eligible for inclusion. The risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis using the inverse-variance-weighted method was performed. RESULTS: We included four retrospective cohort studies with 15 189 175 pregnancies. The overall risk of bias was low to unclear. The meta-analysis revealed associations of HS with APOs, including gestational diabetes mellitus [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.09-1.96], pre-eclampsia/eclampsia (OR 1.18, 95% CI 1.01-1.38), caesarean section (OR 1.31, 95% CI 1.04-1.64) and postpartum haemorrhage (OR 1.39, 95% CI 1.07-1.82). Regarding adverse fetal outcomes, maternal HS was significantly associated with spontaneous abortion (OR 1.19, 95% CI 1.06-1.34), preterm birth (OR 1.17, 95% CI 1.04-1.31) and birth defects (OR 1.47, 95% CI 1.03-2.11). CONCLUSIONS: Pregnant women with HS have an increased risk of APOs, underscoring the need for coordinated care between dermatologists and obstetricians, as well as early diagnosis and intervention to mitigate potential risks to maternal health and fetal development.