Adverse pregnancy outcomes in women with atopic dermatitis: A systematic review and meta-analysis.

BACKGROUND: The impact of atopic dermatitis (AD) on pregnancy outcomes has been largely uncertain, and clarifying this association is essential for improving maternal counselling, risk stratification and clinical management. OBJECTIVES: To assess the association between AD in pregnant women and adverse pregnancy outcomes. METHODS: MEDLINE, Embase and CENTRAL were searched from inception through 7th September 2025. We included cohort studies that assessed the association between AD and pregnancy outcomes. Maternal outcomes included mode of delivery, obstetric complications and maternal mortality. Neonatal outcomes included preterm birth, perinatal mortality, impaired foetal growth, congenital anomalies, neonatal infections and other adverse neonatal outcomes. We used the Newcastle-Ottawa Scale (NOS) to assess the risk of bias of included studies. A random-effects model meta-analysis was undertaken. RESULTS: We included eight cohort studies involving 278,671 women with AD and over 2,738,216 controls. The meta-analysis found associations of maternal AD with premature rupture of membranes [pooled odds ratio (OR) 1.16, 95% confidence interval (CI) 1.09-1.24] and low birth weight (<2500 g, pooled OR 1.11, 95% CI 1.02-1.20). Maternal AD was also associated with increased risk of gestational hypertension (pooled OR 1.15, 95% CI 1.02-1.29) and pre-eclampsia/eclampsia (pooled OR 1.11; 95% CI 1.03-1.19). One study indicated increased neonatal septicaemia caused by Staphylococcal species (OR 2.45, 95% CI 1.33-4.49). CONCLUSIONS: Maternal AD is associated with a modestly increased risk of premature rupture of membranes, gestational hypertension, pre-eclampsia/eclampsia and notably neonatal Staphylococcal septicaemia. Obstetricians and dermatologists should be aware of these risks, monitor pregnancy complications closely and provide appropriate management when necessary.