Maternal Hidradenitis Suppurativa Linked to Increased Risk of Childhood Morbidity

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Maternal cases of hidradenitis suppurativa (HS) were positively associated with an increased risk of childhood morbidity, according to data presented in a poster at the 2024 American Academy of Dermatology (AAD) Annual Meeting in San Diego, California. The poster was awarded a second place poster winner distinction by the AAD.

Study authors Li Kaiyang et al began with the pre-existing understanding that HS is associated with morbidity in cases of women of reproductive age and in adverse pregnancy outcomes. However, its effect on offspring is uncertain.

Researchers thus conducted a retrospective longitudinal cohort study involving more than 1 million (n=1,275,593) children born between the dates of April 1, 2006, and March 31, 2022, in Quebec, Canada. Using identification numbers, researchers matched children with their mothers and tracked morbidities leading to hospital admission up to 16 years of age in the offspring.

Using adjusted Cox proportional hazards regression models, the team estimated hazard ratios and 95% confidence intervals to analyze the association between maternal HS and childhood morbidity.

The findings revealed several associations.

Maternal HS was linked to an increased risk of adverse birth outcomes, including preterm birth, neonatal death, birth defects, congenital heart defects, and orofacial clefts.

Moreover, the study uncovered long-term health implications for children exposed to maternal HS.

Compared to those without maternal HS exposure, children born to mothers with HS had a higher likelihood of experiencing various hospitalizations during childhood. Specifically, they were at increased risk of respiratory, metabolic, gastrointestinal, and developmental hospitalizations.

The study also delved into potential mechanisms underlying these associations. Chronic inflammation, a hallmark of HS, may contribute to adverse birth outcomes and long-term health risks in offspring. Placental biomarkers associated with inflammation, such as IL1b and TNF-a, along with fetal neuroendocrine and immune programming, could play a role in mediating these effects.

Furthermore, prenatal exposure to hyperandrogenism, a hormonal imbalance characteristic of HS, may influence the health outcomes of boys and girls differently.

In addition to hormonal changes, inflammation, and obesity, genetic predispositions may also contribute to the observed associations. Genes such as SOX9 and KLF5 have been implicated in both HS and developmental processes, suggesting a potential genetic link between maternal HS and childhood health outcomes.

Reference

Li K, O’Brien E, Wei SQ, Brousseau É, Auger N. Effect of maternal hidradenitis suppurativa on offspring outcomes. Poster presented at: 2024 American Academy of Dermatology Annual Meeting; March 8-12, 2024; San Diego, CA.