Crossed looks on the dermatologist's position and the patient's preoccupations as to psoriasis and pregnancy: preliminary results of the PREGNAN‐PSO study

Abstract

Background While some information on psoriasis impact on pregnancy is available, very little is known on the preoccupations of women afflicted by the disease or on the dermatologists' (D) positioning as to psoriasis and pregnancy. The 'Objectifs Peau' project demonstrated a 4.7% prevalence of psoriasis in women aged 18-45 years in France.Objective This project sought to further address these issues in view of a targeted action plan.Methods A questionnaire was made available to 361 D of different types. ResultsOverall, 152 D answered the questionnaire, 50.7% working in private or mixed practice and 49.3% in hospitals, with 63% females (DF) and 37% males (DM). Over the last 3 months, the mean percentage of women of child-bearing age seen by these D was 28.6%. The main issue addressed by D upon psoriasis diagnosis was the patient's wish to become pregnant in the short-term (84%), while the compatibility of drug treatment with pregnancy was the issue prioritized by patients (64%). Among DM and DF, 46% and 29% reported having been confronted with an unplanned pregnancy, with their reaction mainly dependent on the treatment taken in 66%. Regarding follow-up, 26% D declared having shared their decision-making with gynaecologists, while 56% considered the first pregnancy trimester to be the highest-risk period. Only 28% D were familiar with existing recommendations, with only 21% of them considering them appropriate.Conclusion Overall, 26.2% of French psoriasis women are of child-bearing potential, in line with our dataset (28.6%). Only 56% D considered the 1st pregnancy trimester to be the highest-risk period, with only one-third familiar with existing recommendations. The gap between recommendations and actual practices must be addressed through policies that take women's preoccupations better into account.

<p>Contraception, Sexuality and Pregnancy in Women with Psoriasis: Real-Life Experience of 235 Women</p>

“…We previously reported on the difficulties of opening up and discussing sexuality with physicians. 2 In a study of 183 couples, we found that psoriasis severity and/or a significant impact on QoL were factors associated with sexual dysfunction in male partners of women with psoriasis, but the opposite scenario was not observed. 7 Contraception in childbearing women with psoriasis is important, and therapeutic options must be considered for all women with psoriasis who are sexually active irrespective of intentions of starting a family.…”

“…In our previous study, dermatologists reported, that upon diagnosing women of childbearing age with psoriasis, they approached short-term desires of pregnancy (83.5%), contraception (68%), long-term desires of pregnancy (41%) and drug therapies during pregnancy (35%). 2 Conversely, according to dermatologists, the main topics discussed by women included compatibility of therapy with pregnancy (64%), disease transmission (54%), foetal risks of therapy (49%), and contraception (32%). 2 However, in the present study, 13-14% of nonpregnant women reported that the physician managing their psoriasis discussed child planning and pregnancy.…”

“…2 Conversely, according to dermatologists, the main topics discussed by women included compatibility of therapy with pregnancy (64%), disease transmission (54%), foetal risks of therapy (49%), and contraception (32%). 2 However, in the present study, 13-14% of nonpregnant women reported that the physician managing their psoriasis discussed child planning and pregnancy. In addition, 61.5% of pregnant patients reported that the physician managing their psoriasis did not talk about the pregnancy during consultations.…”

“…In a previous study, we reported that 26% of women with psoriasis who are seen by a dermatologist are of childbearing age and therefore likely to be pregnant. 2 Women are mostly interested in knowing about treatment compatibility with pregnancy, risks to the foetus and the risk of disease transmission. 2 In the present study, we sought to investigate the real-life experience of these female psoriasis patients with respect to contraception, sexuality and pregnancy.…”

Use of biologics in pregnancy: limitations stemming from clinical trials and registry experience

“…To the Editor, We recently read with interest the results published by Maccari et al 1 in 'Crossed looks on the dermatologist's position and the patient's preoccupations as to psoriasis and pregnancy: preliminary results of the PREGNAN-PSO study'. This study sheds light on knowledge gaps in a cohort of dermatologists' understanding on treatment of psoriasis in pregnancy.…”