Counselling Needs in Atopic Dermatitis: Perspectives on Pregnancy and Treatment
DOI:
https://doi.org/10.2340/actadv.v105.42544Keywords:
atopic dermatits, family planning, pregnancyAbstract
Atopic dermatitis (AD) is a common inflammatory skin disease affecting 5–8% of adults, with many being of reproductive age and potentially experiencing AD- and treatment-related challenges during family planning and pregnancy (FPP). This study examined whether patients with AD receive FPP-related information from their dermatologist and their concerns about pregnancy and breastfeeding. A cross-sectional questionnaire study was conducted among 18–45-year-old patients with AD treated at dermatology departments in university hospitals or private dermatology clinics in Denmark, all undergoing either topical or systemic treatment. A total of 121 patients participated in the study. The most pronounced concern was the heritable nature of AD (88.4%), followed by concerns about the teratogenicity of their treatments (29.8%). Additionally, 37.1% of women expressed concern about their ability to breastfeed. One-third of patients with AD had discussed FPP with their dermatologists prior to pregnancy, and 15% reported having fewer biological children than they desired due to their disease. Adult patients with AD have significant unmet informational needs regarding FPP. Addressing these concerns at appropriate stages in their lives, potentially through structured communication, could provide patients with better opportunities to address their concerns and plan their family life based on comprehensive and accurate information.
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Bosma AL, Ascott A, Iskandar R, Farquhar K, Matthewman J, Langendam MW, et al. Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics. J Eur Acad Dermatol Venereol 2022; 36: 807-819.
https://doi.org/10.1111/jdv.18008 DOI: https://doi.org/10.1111/jdv.18008
Kim JP, Chao LX, Simpson EL, Silverberg JI. Persistence of atopic dermatitis (AD): A systematic review and meta-analysis. J Am Acad Dermatol 2016; 75: 681-687.e611.
https://doi.org/10.1016/j.jaad.2016.05.028 DOI: https://doi.org/10.1016/j.jaad.2016.05.028
Vakharia PP, Silverberg JI. Adult-onset atopic dermatitis: characteristics and management. Am J Clin Dermatol 2019; 20: 771-779.
https://doi.org/10.1007/s40257-019-00453-7 DOI: https://doi.org/10.1007/s40257-019-00453-7
Nygaard U, Deleuran M, Vestergaard C. Emerging treatment options in atopic dermatitis: topical therapies. Dermatology 2017; 233: 333-343.
https://doi.org/10.1159/000484407 DOI: https://doi.org/10.1159/000484407
Legat FJ. Itch in Atopic Dermatitis - What Is New? Front Med (Lausanne) 2021; 8: 644760.
https://doi.org/10.3389/fmed.2021.644760 DOI: https://doi.org/10.3389/fmed.2021.644760
Sundhed.dk. Atopisk eksem. 2024. [cited: 18.03.2024]. Available from: https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/hud/tilstande-og-sygdomme/skaellende-hudlidelser/atopisk-eksem/
Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol 2019; 80: 1526-1532.e1527.
https://doi.org/10.1016/j.jaad.2018.05.1241 DOI: https://doi.org/10.1016/j.jaad.2018.05.1241
Vestergaard C, Wollenberg A, Barbarot S, Christen-Zaech S, Deleuran M, Spuls P, et al. European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period. J Eur Acad Dermatol Venereol 2019; 33: 1644-1659.
https://doi.org/10.1111/jdv.15709 DOI: https://doi.org/10.1111/jdv.15709
Hamann CR, Egeberg A, Wollenberg A, Gislason G, Skov L, Thyssen JP. Pregnancy complications, treatment characteristics and birth outcomes in women with atopic dermatitis in Denmark. J Eur Acad Dermatol Venereol 2019; 33: 577-587.
https://doi.org/10.1111/jdv.15256 DOI: https://doi.org/10.1111/jdv.15256
Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform 2019; 95: 103208.
https://doi.org/10.1016/j.jbi.2019.103208 DOI: https://doi.org/10.1016/j.jbi.2019.103208
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377-381.
https://doi.org/10.1016/j.jbi.2008.08.010 DOI: https://doi.org/10.1016/j.jbi.2008.08.010
Walldorf J, Brunne S, Gittinger FS, Michl P. Family planning in inflammatory bowel disease: childlessness and disease-related concerns among female patients. Eur J Gastroenterol Hepatol 2018; 30: 310-315.
https://doi.org/10.1097/MEG.0000000000001037 DOI: https://doi.org/10.1097/MEG.0000000000001037
Lynch M, Peinado S, Treiman K, McDaniel C, Vinci A, Creek E. Information needs across the family planning continuum: A survey of women with chronic autoimmune inflammatory conditions. Patient Educ Couns 2020; 103: 103-111.
https://doi.org/10.1016/j.pec.2019.08.005 DOI: https://doi.org/10.1016/j.pec.2019.08.005
Walldorf J, Pijan E, Greinert R, Riesner-Wehner A, Michl P. Family planning with inflammatory bowel disease: the challenge of childlessness and parent concerns. Z Gastroenterol 2021; 59: 841-850.
https://doi.org/10.1055/a-1404-3610 DOI: https://doi.org/10.1055/a-1404-3610
Johansen CB, Laurberg TB, Egeberg A, Jensen UA, Hansen AL, Skov L, et al. Awareness and expectations surrounding family planning and pregnancy among danish patients with chronic inflammatory disease of the skin or joints: results from an online survey. Rheumatol Ther 2021; 8: 1419-1433.
https://doi.org/10.1007/s40744-021-00348-2 DOI: https://doi.org/10.1007/s40744-021-00348-2
Huang VW, Chang HJ, Kroeker KI, Goodman KJ, Hegadoren KM, Dieleman LA, et al. Does the level of reproductive knowledge specific to inflammatory bowel disease predict childlessness among women with inflammatory bowel disease? Can J Gastroenterol Hepatol 2015; 29: 95-103.
https://doi.org/10.1155/2015/715354 DOI: https://doi.org/10.1155/2015/715354
Danmarks_statistik. Gennemsnitsalder for fødende kvinder og nybagte fædre efter alder og tid (2023). 2022. [Cited: July 2024]. Available from: https://www.statistikbanken.dk/statbank5a/default.asp?w=1512.]
Chakravarty E, Clowse ME, Pushparajah DS, Mertens S, Gordon C. Family planning and pregnancy issues for women with systemic inflammatory diseases: patient and physician perspectives. BMJ Open 2014; 4: e004081.
https://doi.org/10.1136/bmjopen-2013-004081 DOI: https://doi.org/10.1136/bmjopen-2013-004081
Alcantara-Luna S, Ruiz-Villaverde R, Domínguez-Cruz J, Galán-Gutiérrez M, Navarro-Triviño F, Pereyra-Rodriguez JJ, et al. Validation of a questionnaire to assess the perception of women with atopic dermatitis in family planning. Int J Environ Res Public Health 2022; 19: 10753.
https://doi.org/10.3390/ijerph191710753 DOI: https://doi.org/10.3390/ijerph191710753
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