In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether psoriasis or psoriatic arthritis may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider.

What are psoriasis and psoriatic arthritis?

Psoriasis is a skin condition in which skin cells grow faster than expected. This can leave dry, thick patches on the skin. Plaque psoriasis is the most common form of this chronic condition. It usually affects skin on the elbows, knees, buttocks and scalp. Psoriasis is not contagious so you cannot catch it from another person. While the exact causes are not known, the immune system is probably involved. In addition to having dry skin, up to one out of every three people (approximately 33 percent) living with psoriasis will also develop swollen and painful joints (this is called psoriatic arthritis or PsA). Like psoriasis, symptoms of psoriatic arthritis can be mild or severe.

Will psoriasis or psoriatic arthritis make it harder for me to get pregnant?

We don’t know if fertility is affected by psoriasis or psoriatic arthritis, but there is no established risk. One study did not find an increase in time to become pregnant among women with mild to moderate psoriasis. No study has been found looking specifically at psoriatic arthritis.

How will pregnancy affect my symptoms?

Health care providers are not able to predict how a woman’s symptoms might change, if at all, during pregnancy. Women report symptoms that improve, stay the same, or worsen during pregnancy. In general, it appears that more women improve or stay the same rather than get worse. However, a flare up of symptoms after delivery is common.

I have psoriasis or psoriatic arthritis. Will this increase the chance of a birth defect?

There are no studies that look at the effects of psoriasis or psoriatic arthritis and the chance of having a baby with a birth defect. Treating your condition with medication may or may not affect your chances. We recommend discussing your treatment options with your health care provider, so they can work with you to manage your medical condition during pregnancy.

Can having psoriasis or psoriatic arthritis increase the chance for pregnancy complications?

It isn’t clear, but there is no established risk. Some studies have suggested that psoriasis increases the chance for miscarriage, pre-eclampsia or the need for cesarean delivery. Pre-eclampsia is a serious form of high blood pressure that can cause life-threatening complications for mother and baby. However, other studies have found no increased chance for these pregnancy complications. The chance for pregnancy complications may depend on whether the symptoms of psoriasis are mild or severe.

Whether psoriasis can affect the growth of the baby is also not clear. While one study found that women with severe psoriasis were more likely to have a baby with low birth weight, another study found women with moderate to severe psoriasis were more likely to have a baby with a heavier birth weight.

We did not locate controlled studies specific to pregnancy outcomes with psoriatic arthritis alone.

I am taking medication for psoriasis or psoriatic arthritis. Can I take my medication during pregnancy?

Some medicines used to treat psoriasis and psoriatic arthritis are known to cause birth defects, but others have not been associated with a risk to the developing baby. For information on specific therapies, see our medication fact sheets at http://mothertobaby.wpengine.com/fact-sheets-parent/ or contact MotherToBaby toll-free at 1-866-626-6847. It is important that you discuss treatment options with your health care providers when planning pregnancy, or as soon as you learn that you are pregnant.

I would like to breastfeed my baby. Are my medications safe to use while breastfeeding?

Breastfeeding with psoriasis is acceptable since it is a non-contagious condition. Many medications can be used while breastfeeding. However, while most medications are low risk, others may be concerning or require a special follow-up for the baby. For information on specific medications, see our fact sheets or contact MotherToBaby. Be sure to talk to your health care provider about breastfeeding.

My partner has psoriasis or psoriatic arthritis and uses medication to treat his symptoms. Will this affect his ability to have children or increase our chances of having a child with a birth defect?

Certain medicines used to treat psoriasis or psoriatic arthritis could have an effect on a man’s sperm production. This could make it harder to get pregnant. Other medicines are not thought to have an effect on sperm. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at http://mothertobaby.wpengine.com/fact-sheets/paternal-exposures-pregnancy/pdf/.

MotherToBaby is currently conducting a study looking at psoriasis, psoriatic arthritis, and the medications used to treat these conditions in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or sign up at http://mothertobaby.wpengine.com/join-study/.

References available upon request.