Pregnancy in Women with Atopic Dermatitis: A Systematic Review of Concerns and Challenges
DOI:
https://doi.org/10.2340/actadv.v106.adv-2026-0608Keywords:
atopic dermatitis, atopic eczema, atopy, pregnancy, family planningAbstract
Atopic dermatitis (AD) has negative individual and societal implications. However, the potential impact of ADatopic dermatitis on reproduction has only been sporadically investigated. We aimed to provide an overview of pregnancy in ADatopic dermatitis, with a specific focus on concerns, challenges, the number of children, and adverse pregnancy and birth outcomes. A systematic literature search was performed using EMBASE and PubMed up until 19th January 2026 for original articles in relation to reproduction in female ADatopic dermatitis. Twenty-four highly heterogeneous studies were included. Concerns about ADatopic dermatitis in relation to pregnancy and family planning were reported in >50% of the patients in three3 out of four4 studies. Conflicting results were seen regarding fertility and disease severity during pregnancy. Pregnancy rates were similar or increased based on two2 studies. Eleven studies addressed adverse pregnancy and birth outcomes, of which five5 studies unanimously reported a protective or indifferent effect of ADatopic dermatitis on pre-term birth, gestational diabetes and stillbirth. Outcomes such as gestational hypertension, preeclampsia and miscarriage showed divergent results. Overall, ADatopic dermatitis causes considerable worries in relation to family planning. However, this review implies, that pregnancy rates as well as complications in pregnancy and during childbirth in women with ADatopic dermatitis overall are consistent with women without ADatopic dermatitis.
Downloads
References
Volke A, Toompere K, Laisaar KT, Oona M, Tisler A, Johannson A, et al. 12-month prevalence of atopic dermatitis in resource-rich countries: a systematic review and meta-analysis. Sci Rep 2022; 12: 15125. DOI: https://doi.org/10.1038/s41598-022-19508-7
Barbarot S, Auziere S, Gadkari A, Girolomoni G, Puig L, Simpson EL, et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy 2018; 73: 1284–1293. DOI: https://doi.org/10.1111/all.13401
Fowler JF, Duh MS, Rovba L, Buteau S, Pinheiro L, Lobo F, et al. The direct and indirect cost burden of atopic dermatitis: an employer-payer perspective. Manag Care Interface 2007; 20: 26–32.
Fougerousse AC, Alexandre M, Darrigade AS, Merhand S, Marquié A, Hamza M, et al. Impact of atopic dermatitis on adult women’s lives: a survey of 1,009 French women. Acta Derm Venereol 2024; 104: adv10321. DOI: https://doi.org/10.2340/actadv.v104.10321
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. DOI: https://doi.org/10.1111/jdv.15256
Pálsson K, Slagor RM, Flachs EM, Nørreslet LB, Agner T, Ebbehøj NE. Childhood atopic dermatitis is associated with a decreased chance of completing education later in life: a register-based cohort study. J Eur Acad Dermatol Venereol 2021; 35: 1849–1858. DOI: https://doi.org/10.1111/jdv.17346
Nørreslet LB, Ebbehøj NE, Ellekilde Bonde JP, Thomsen SF, Agner T. The impact of atopic dermatitis on work life - a systematic review. J Eur Acad Dermatol Venereol 2018; 32: 23–38. DOI: https://doi.org/10.1111/jdv.14523
Slagor RM, Nørreslet LB, Ebbehøj NE, Bonde JP, Thomsen SF, Agner T. Atopic dermatitis is associated with increased use of social benefits: a register-based cohort study. J Eur Acad Dermatol Venereol 2020; 34: 549–557. DOI: https://doi.org/10.1111/jdv.15902
Johansen CB, Laurberg TB, Egeberg A, Jensen UFA, 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. DOI: https://doi.org/10.1007/s40744-021-00348-2
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: 19. DOI: https://doi.org/10.3390/ijerph191710753
Skovsgård CH, Frølunde AS, Deleuran M, Thyssen JP, Thomsen SF, Vestergaard C. Counselling needs in atopic dermatitis: perspectives on pregnancy and treatment. Acta Derm Venereol 2025; 105: adv42544. DOI: https://doi.org/10.2340/actadv.v105.42544
Sunyer J, Antó JM, Plana E, Janson C, Jarvis D, Kony S, et al. Maternal atopy and changes in parity. Clin Exp Allergy 2005; 35: 1028–1032. DOI: https://doi.org/10.1111/j.1365-2222.2005.02300.x
Bláfoss J, Hansen AV, Malchau Lauesgaard SS, Ali Z, Ulrik CS. Female asthma and atopy - impact on fertility: a systematic review. J Asthma Allergy 2019; 12: 205–211. DOI: https://doi.org/10.2147/JAA.S203576
Covidence systematic review software VHI, Melbourne, Australia.
La Torre G, Chiaradia G, Gianfagna F, De Laurentis A, Boccia S. Quality assessment in meta-analysis. Ijph 2006; 3: 44–50. DOI: https://doi.org/10.2427/5937
Seeger JD, Lanza LL, West WA, Fernandez C, Rivero E. Pregnancy and pregnancy outcome among women with inflammatory skin diseases. Dermatology 2007; 214: 32–39. DOI: https://doi.org/10.1159/000096910
Schmidt SAJ, Farkas DK, Deleuran MS, Vestergaard C, Sørensen HT, Skipper N, et al. Long-term socioeconomic outcomes in Danish children with moderate-to-severe atopic dermatitis. J Eur Acad Dermatol Venereol 2026; 40: 79–89. DOI: https://doi.org/10.1111/jdv.70085
Fuentes-Barragán L, García-Moronta C, Sanabria-de la Torre R, León-Pérez FJ, Molina-Leyva A, Arias-Santiago S, et al. Impact on major life-changing decisions in patients with atopic dermatitis. Acta Derm Venereol 2025; 105: adv42241. DOI: https://doi.org/10.2340/actadv.v105.42241
Horev A, Shalom G, Weintraub AY, Freud T, Cohen AD. Atopic dermatitis and infertility: a nationwide retrospective cohort study. Dermatology 2022; 238: 313–319. DOI: https://doi.org/10.1159/000515600
Liu A, Akimova ET, Ding X, Jukarainen S, Vartiainen P, Kiiskinen T, et al. Evidence from Finland and Sweden on the relationship between early-life diseases and lifetime childlessness in men and women. Nat Hum Behav 2024; 8: 276–287. DOI: https://doi.org/10.1038/s41562-023-01763-x
Savilahti E, Siltanen M, Pekkanen J, Kajosaari M. Mothers of very low birth weight infants have less atopy than mothers of full-term infants. Clin Exp Allergy 2004; 34: 1851–1854. DOI: https://doi.org/10.1111/j.1365-2222.2004.02122.x
Trønnes H, Wilcox AJ, Markestad T, Tollånes MC, Lie RT, Moster D. Associations of maternal atopic diseases with adverse pregnancy outcomes: a national cohort study. Paediatr Perinat Epidemiol 2014; 28: 489–497. DOI: https://doi.org/10.1111/ppe.12154
Saito M, Yamamoto-Hanada K, Pak K, Ayabe T, Mezawa H, Ishitsuka K, et al. Having small-for-gestational-age infants was associated with maternal allergic features in the JECS birth cohort. Allergy 2018; 73: 1908–1911. DOI: https://doi.org/10.1111/all.13490
Rodríguez-Pozo JA, Montero-Vílchez T, Diaz Calvillo P, Sanabria de la Torre R, Ureña Paniego C, Ramirez-Muñoz A, et al. The impact of atopic dermatitis on sexual function and reproductive desires in women. Acta Derm Venereol 2024; 104: adv35107. DOI: https://doi.org/10.2340/actadv.v104.35107
Cho S, Kim HJ, Oh SH, Park CO, Jung JY, Lee KH. The influence of pregnancy and menstruation on the deterioration of atopic dermatitis symptoms. Ann Dermatol 2010; 22: 180–185. DOI: https://doi.org/10.5021/ad.2010.22.2.180
Kemmett D, Tidman MJ. The influence of the menstrual cycle and pregnancy on atopic dermatitis. Br J Dermatol 1991; 125: 59–61. DOI: https://doi.org/10.1111/j.1365-2133.1991.tb06041.x
Olsson Mägi CA, Bjerg Bäcklund A, Lødrup Carlsen K, Almqvist C, Carlsen KH, Granum B, et al. Allergic disease and risk of stress in pregnant women: a PreventADALL study. ERJ Open Res 2020; 6: 6. DOI: https://doi.org/10.1183/23120541.00175-2020
Kjersgaard CL, Gaml-Sørensen A, Clemmensen PJ, Arendt LH, Håberg SE, Arah OA, et al. Atopic dermatitis and fecundity: a Danish National Birth Cohort study. Hum Reprod Open 2026; 2026: hoaf077. DOI: https://doi.org/10.1093/hropen/hoaf077
Rakita U, Kaundinya T, Silverberg JI. Lack of association between atopic dermatitis severity and worsening during pregnancy: a cross-sectional study. J Am Acad Dermatol 2022; 86: 438–440. DOI: https://doi.org/10.1016/j.jaad.2021.09.066
Tata LJ, Hubbard RB, McKeever TM, Smith CJP, Doyle P, Smeeth L, et al. Fertility rates in women with asthma, eczema, and hay fever: a general population-based cohort study. Am J Epidemiol 2007; 165: 1023–1030. DOI: https://doi.org/10.1093/aje/kwk092
Weng PC, Zhang JF, Kuo CF, Huang YH. Atopic dermatitis and the outcomes of pregnancy and offspring: a nationwide population-based study in Taiwan. J Dtsch Dermatol Ges 2025; 23: 54–63. DOI: https://doi.org/10.1111/ddg.15555
Barbieri JS, Shin DB, Margolis DJ. Atopic dermatitis is associated with preeclampsia and endometriosis. JID Innov 2022; 2: 100123. DOI: https://doi.org/10.1016/j.xjidi.2022.100123
Sugiura-Ogasawara M, Suzuki S, Ozaki Y, Katano K, Suzumori N, Kitaori T. Frequency of recurrent spontaneous abortion and its influence on further marital relationship and illness: the Okazaki Cohort Study in Japan. J Obstet Gynaecol Res 2013; 39: 126–131. DOI: https://doi.org/10.1111/j.1447-0756.2012.01973.x
Kojima R, Yokomichi H, Akiyama Y, Ooka T, Miyake K, Horiuchi S, et al. Association between preterm birth and maternal allergy considering IgE level. Pediatr Int 2021; 63: 1026–1032. DOI: https://doi.org/10.1111/ped.14635
Isogami H, Murata T, Imaizumi K, Fukuda T, Kanno A, Kyozuka H, et al. Association between atopic dermatitis in pregnant women and preterm births: the Japan Environment and Children’s Study. Matern Child Health J 2024; 28: 1570–1577. DOI: https://doi.org/10.1007/s10995-024-03950-2
Saito-Abe M, Yamamoto-Hanada K, Pak K, Sato M, Irahara M, Mezawa H, et al. Association of maternal history of allergic features with preterm pregnancy outcomes in the Japan Environment and Children’s Study. Int Arch Allergy Immunol 2021; 182: 650–662. DOI: https://doi.org/10.1159/000513749
Hanzlikova J, Ulcova-Gallova Z, Malkusova I, Sefrna F, Panzner P. TH1-TH2 response and the atopy risk in patients with reproduction failure. Am J Reprod Immunol 2009; 61: 213–220. DOI: https://doi.org/10.1111/j.1600-0897.2009.00683.x
Margolis DJ, Mitra N, Hoffstad OJ, Kim BS, Monos DS, Phillips EJ. Association of KIR genes and MHC class I ligands with atopic dermatitis. J Immunol 2021; 207: 1522–1529. DOI: https://doi.org/10.4049/jimmunol.2100379
Hiby SE, Walker JJ, O’shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal KIR and fetal HLA-C genes influence the risk of preeclampsia and reproductive success. J Exp Med 2004; 200: 957–965. DOI: https://doi.org/10.1084/jem.20041214
Totté JEE, van der Feltz WT, Hennekam M, van Belkum A, van Zuuren EJ, Pasmans SGMA. Prevalence and odds of Staphylococcus aureus carriage in atopic dermatitis: a systematic review and meta-analysis. Br J Dermatol 2016; 175: 687–695. DOI: https://doi.org/10.1111/bjd.14566
Additional Files
Published
How to Cite
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.