Females with moderate to severe psoriasis are less fertile than controls, UK research has found. The study also revealed that female psoriasis patients are more likely to experience pregnancy loss. 

Researchers matched 63,681 patients aged between 15 and 44 years with psoriasis to 318,405 controls without the skin disease. Participants’ median age was 30 years and 5.1 per cent had moderate to severe psoriasis during the median follow-up of 4.1 years.

Overall, fertility was 30 per cent higher in people with psoriasis than controls. However, in moderate to severe psoriasis, the fertility rate was 25 per cent lower than controls. 

After allowing for confounders, the likelihood that pregnancy would end with a live birth was 9 per cent lower in people with psoriasis and 18 per cent lower in those with moderate to severe psoriasis. Overall, pregnancy loss was significantly more common in psoriasis patients (by 5 per cent) than controls. In 95.5 per cent of cases, pregnancy loss occurred during the first trimester. 

Further studies should assess the mechanism responsible for the increased risk of pregnancy loss among psoriasis patients and assess improved psoriasis management and closer monitoring during pregnancy.

JAMA Dermatol. doi:10.1001/jamadermatol.2023.1400