Pregnant Women with Psoriasis Increased Cardiovascular Risks During Delivery

Growing Concerns Over Pregnancy Complications in Women with Psoriasis

A recent study has shed light on the alarming connection between psoriasis and an increased risk of cardiovascular complications during pregnancy. The chronic inflammatory skin disease, primarily known for its dermatological impact, has now been linked to serious maternal health concerns, particularly during delivery hospitalization.

Psoriasis affects millions worldwide and its association with systemic inflammation has long been recognized. However, its specific implications for pregnant women have remained understudied. This study underscores the urgent need for healthcare professionals to closely monitor pregnant individuals with psoriasis, given their heightened risk of cardiovascular complications.

Understanding the Link Between Psoriasis and Cardiovascular Risks

Psoriasis has been identified as an independent risk factor for cardiovascular disease (CVD), contributing to heart failure, atrial fibrillation, myocardial infarction and stroke. In reproductive-age women, the inflammatory nature of psoriasis can lead to maternal complications such as preeclampsia, gestational hypertension and delivery-related risks.

The study analyzed data from the National Inpatient Sample (NIS) database, which spans from 2011 to 2020. The NIS, the largest publicly available inpatient healthcare database in the U.S., provided valuable insights into the prevalence and impact of psoriasis during delivery hospitalizations.

Key Findings and Statistical Analysis

Out of 37.48 million delivery hospitalizations, 23,945 patients (63 per 100,000) were diagnosed with psoriasis. Compared to those without the condition, patients with psoriasis had the following characteristics:

• A slightly higher average age (30.8 vs. 28.8 years)

• Greater likelihood of multiple gestations (2.4% vs. 2.0%)

• Increased prevalence of pre-existing conditions, including hypertension, diabetes, hyperlipidemia, chronic kidney disease and obesity

The study found that pregnant women with psoriasis had significantly higher rates of cardiovascular complications, including:

• Preeclampsia/eclampsia (5.5% vs. 3.5%)

• Acute kidney injury (0.2% vs. 0.08%)

• Cardiac arrhythmias (1.4% vs. 0.8%)

• Venous thromboembolism (0.2% vs. 0.06%)

Unadjusted analysis demonstrated that psoriasis was significantly associated with preeclampsia/eclampsia (OR: 1.60), cardiac arrhythmia (OR: 1.65), venous thromboembolism (OR: 2.69) and acute kidney injury (OR: 2.53).

After adjusting for demographic and clinical variables, preeclampsia/eclampsia (OR: 1.25) and cardiac arrhythmias (OR: 1.44) remained statistically significant.

Rising Trends in Delivery Hospitalizations for Women with Psoriasis

Over the decade, the prevalence of delivery hospitalizations for psoriasis patients has steadily increased, with an average of 0.064% per year. This growing trend may reflect better awareness, improved diagnostic practices and increased healthcare access for individuals with psoriasis.

Healthcare experts speculate that this increase may be due to several factors, including improved recognition of psoriasis in pregnant women and enhanced documentation of pre-existing conditions. Regardless of the cause, the study highlights the need for targeted maternal care strategies.

Why Psoriasis Increases Cardiovascular Risks During Pregnancy

The systemic inflammation associated with psoriasis is believed to contribute to its cardiovascular effects. Chronic inflammation can impair vascular function, leading to increased blood pressure and reduced placental blood flow. This inflammatory process can disrupt spiral artery remodeling, resulting in placental ischemia, oxidative stress and an elevated risk of hypertensive disorders like preeclampsia.

Additionally, psoriasis-induced inflammation may contribute to myocardial fibrosis, arrhythmias and thrombotic complications, further elevating maternal cardiovascular risks during pregnancy. These findings reinforce the need for proactive management strategies to mitigate these risks.

Clinical Implications: The Need for Multidisciplinary Care

The study underscores the importance of a collaborative approach in managing pregnant individuals with psoriasis. Obstetricians, dermatologists, cardiologists and rheumatologists should work together to ensure comprehensive care, focusing on:

• Regular cardiovascular screening for high-risk patients

• Early interventions to manage hypertension and metabolic disorders

• Close monitoring of inflammatory markers throughout pregnancy

Given the strong association between psoriasis and adverse pregnancy outcomes, early identification of at-risk individuals is crucial. Personalized treatment plans should be implemented to reduce complications and improve both maternal and neonatal health.

Key Insights

This study highlights a crucial aspect of maternal healthcare—pregnant women with psoriasis face a significantly higher risk of cardiovascular complications during delivery. With the increasing prevalence of delivery hospitalizations for this patient population, there is an urgent need for targeted screening and intervention strategies.

As psoriasis continues to be recognized as more than just a dermatological condition, healthcare providers must adapt their approaches to better manage its systemic effects. By integrating cardiovascular risk assessment into prenatal care, physicians can help ensure safer pregnancy outcomes for women with psoriasis, ultimately reducing maternal morbidity and improving overall healthcare outcomes.

By - Eeshan Aggarwal

Reference:

Agrawal A, Sorathia S, Bhagat U, Zahid S, Arockiam AD, Bayat A, Safdar A, Rosenzveig A, Majid M, Chandna S, Gupta R. Cardiovascular Complications During Delivery Hospitalization in Patients With Psoriasis. JACC: Advances. 2025 Feb 1;4(2):101562.