: Jin Cheol Kim, Se Young Na, Jee Woong Choi
Impact of alopecia areata on subsequent pregnancy rate: a retrospective cohort study
Objectives: We investigated the effect of AA on pregnancy rate using data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC).
Introduction: Alopecia areata (AA) is thought to be a cell-mediated autoimmune disease. To date, it is known that many autoimmune diseases are related to pregnancy outcomes. However, there has been no previous study of how AA affects subsequent chance of pregnancy.
Materials / method: A retrospective cohort study of 1,382 fertile female patients with AA and 6,910 1:5 index date-, age group-, sex-, and income level-matched control subjects was performed from 2002 to 2013 using the NHIS-NSC. We defined severe AA patients as those having alopecia totalis, alopecia universalis or ophiasis; others were defined as mild AA, and longstanding AA patients as those having 12 or more diagnostic codes for AA and over a year of the disease duration.
Results: The 5-year cumulative probability of first pregnancy in the AA group was significantly lower than that in the control group (log-rank p-value <0.001). The chance of first pregnancy in the mild AA group (adjusted HR 0.79; 95% CI 0.70-0.90) and longstanding AA group (adjusted HR 0.62; 95% CI 0.43-0.87) were significantly lower than that in the control group. The impact of AA on subsequent pregnancy was significant for patients diagnosed in all age groups except those in the youngest age group.
Conclusion: AA could delay the subsequent pregnancy, especially in patients with more longstanding AA. Therefore, clinicians should consider factors influencing subsequent pregnancy when managing women patients with AA, especially in patients with longer duration of disease.
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