Systematic review and meta-analyses:Fever in pregnancy and health impacts in the offspring

BACKGROUND AND OBJECTIVE:Fever during pregnancy has been suspected to harm the developing fetus. However, until now, no systematic analysis of the available evidence has been undertaken to assess the impact of maternal fever on health outcomes in the child. The goal of this study was to systematically review evidence from epidemiologic studies on adverse health outcomes of the offspring in relation to exposure to maternal fever during pregnancy.METHODS:Systematic searches in PubMed, Web of Science, and the Cochrane Library were performed by using Medical Subject Headings, Boolean operators, and truncation, and references of references were reviewed. Cohort and case-control studies addressing health outcomes of prenatal fever exposure in humans were eligible for inclusion. Studies with no direct reference to fever, studies in selected populations (eg, preterm births), and studies published before 1990 were excluded.RESULTS:The available literature supported an increased risk of adverse offspring health in association with fever during pregnancy. The strongest evidence was available for neural tube defects, congenital heart defects, and oral clefts, in which meta-analyses suggested between a 1.5- and nearly 3-fold increased risk with fever exposure in the first trimester. We did not find strong evidence of a dose–response relationship, but there was some evidence that antipyretic medications may have a protective effect when used in relation to febrile episodes.CONCLUSIONS:We found substantial evidence to support the contention that maternal fever during pregnancy may negatively affect offspring health. The harmful effects seemed to cover both short- and longer-term health outcomes; however, for several outcomes, the evidence was insufficient to judge any association.</jats:sec

Psoriasis as a Predictor of Cardiometabolic Comorbidity in Women:A Study Based on the Danish National Birth Cohort

Psoriasis is associated with cardiometabolic comorbidity; however, whether this is due to common lifestyle-related risk factors is unclear. This study investigated the association between psoriasis and cardiometabolic comorbidity, taking body mass index and smoking into account. The population comprised expectant mothers in the Danish National Birth Cohort (established 1996–2002). During pregnancy, the women were asked about physician-diagnosed psoriasis. Any association with self-reported cardiometabolic comorbidity 11 years later was assessed using logistic regression. The cohort was also followed up for hospital-diagnosed comorbidity, including cardiac death, until 31 December 2014, and the risk was assessed using Cox regression. A total of 2,435 women with psoriasis (2.90%) and 81,388 women without were identified. Psoriasis was significantly associated with self-reported hypercholesterolaemia (adjusted odds ratio 1.31; 1.01–1.70) and hospital-diagnosed hypertension (adjusted hazard ratio 1.33; 1.08–1.65). Women with psoriasis have an increased risk of developing cardiometabolic comorbidity in early adult life