Maternal pruritus gravidarum and its long-term effect on dermatological morbidity in the offspring

Abstract

Purpose

Pruritus gravidarum is characterized by general pruritus in the absence of primary skin lesions. In this study, we sought to evaluate whether the offspring (≤ 18 years) of mothers diagnosed with pruritus gravidarum, are at increased risk of long-term dermatology-related hospitalization.

Methods

A population-based, retrospective cohort study of all singleton deliveries between 1991 and 2021 was conducted at a tertiary medical center. Offspring of mothers diagnosed with pruritus gravidarum were compared to offspring of non-exposed mothers. First admission involving dermatological morbidity of the offspring were analyzed using ICD-9 codes. Kaplan-Meier survival curves were used to compare the cumulative hospitalization incidence between the groups and Cox regression models were utilized to adjust for confounding variables.

Results

A total of 849 women out of 356,356 deliveries that fulfilled the inclusion criteria were diagnosed with pruritus gravidarum during pregnancy (0.23%). Among offspring to mothers with pruritus gravidarum versus non-pruritus gravidarum mothers, hospitalization rates involving dermatological morbidity, were higher (7.1% vs. 4.6%, p < .001) a finding that was consistent with the Kaplan-Meier survival curve (Log rank p = .002). In the Cox regression model, pruritus gravidarum was found to be a significant independent risk factor for dermatological-related hospitalizations in the offspring after controlling for gestational age, hypertensive disorders, diabetic disorders, meconium-stained amniotic fluid exposure and fertility treatments (adjusted HR = 1.44, 95% CI 1.12–1.85, p = .004).

Conclusions

Maternal pruritus gravidarum is an independent risk factor for long-term dermatology-related hospitalization in the offspring up to the age of 18 years.

Keywords:

• Pruritus gravidarum
• pediatric dermatology morbidity
• follow up
• pruritus during pregnancy
• long-term morbidity

Acknowledgments

This study was not funded. All authors have indicated they have no financial relationships relevant to this article to disclose.

Ethics approval

This retrospective study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments (Helsinki Declaration 1975, revision 2013), and its later amendments or comparable ethical standards, and was approved by the institutional review board (SUMC IRB Committee).

Authors’ contributions

All authors contributed to the study conception and design. The first draft of the manuscript was written by Govrin-Yehudain Yoad and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and material

We have full control of all primary data and agree to allow the journal to review the data if requested.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.