Treatment patterns and outcomes in patients with chronic urticaria during pregnancy: Results of PREG-CU, a UCARE Study

Introduction: Chronic urticaria (CU) is a common disease that primarily affects females. Although commonly encountered, there is little data on how pregnancy interact with CU. We analysed treatment use by CU patients before, during and after pregnancy as well as outcomes of pregnancy. Material and Methods: PREG-CU was a prospective and retrospective, international, multicentre, study of the Urticaria Centers of Reference and Excellence (UCARE) network. Data were collected via a 47-item-questionnaire completed by CU patients who became pregnant during their disease course. Results: Questionnaires from 288 CU patients from 13 countries were analysed. During pregnancy, most patients (60%) used urticaria medication (standard dose second generation H1-antihistamines [SD-sgAH] (35.1%), first generation H1-antihistamines (7.6%), high-dose sgAH (5.6%), and omalizumab (5.6%). The preterm birth rate was 10.2%, and preterm rates of patients who did and did not receive treatment during pregnancy were similar (11.6% vs 8.7%). Emergency referrals for CU and twin birth were risk factors for preterm birth. The caesarean delivery rate was 51.3%. More than 90% of new-borns. were healthy at birth. There was no link between any patient or disease characteristics or treatments and medical problems at birth. Eight of 10 (78.8%) women with CU breastfed their babies and most (54.3%) used urticaria medication while breastfeeding. Conclusion: Rates of preterm births and medical problems of new-borns in patients with CU were similar to population norms and not linked to treatment used during pregnancy. Emergency referrals increase risk of preterm birth and emphasizes the importance of urticaria control during pregnancy.