Atopic Dermatitis: Fertility, Pregnancy, and Treatment Perspectives

Am J Clin Dermatol. 2024 Jan;25(1):55-66. doi: 10.1007/s40257-023-00821-4. Epub 2023 Oct 30.

Abstract

Hormonal and immunologic changes during pregnancy can contribute to the development of different dermatoses, the most common of which is atopic eruption of pregnancy (AEP). Of atopic dermatitis (AD) cases during pregnancy, 80% are new-onset presentations, while 20% represent recurrences or exacerbations of preexisting disease. Evidence on the effects of previous AD on fertility is limited. Different factors influence women's desire to conceive in this setting, and it has been hypothesized that barrier defects and systemic inflammation could contribute to biologic infertility, although more data are needed. Clinical practice suggests a tendency toward undertreatment in pregnant woman due to concerns about potential effects on obstetric and fetal outcomes. However, pregnant women should be offered adequate and safe treatments, preferably on an individual basis. The aim of this review was to summarize the evidence on disease course in pregnant women with AD and the challenges associated with its diagnosis and management. We also review the current evidence on the use of conventional and novel systemic therapies for AD in this population.

Publication types

  • Review

MeSH terms

  • Dermatitis, Atopic* / drug therapy
  • Dermatitis, Atopic* / therapy
  • Disease Progression
  • Female
  • Fertility
  • Humans
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / epidemiology
  • Pregnancy Complications* / therapy