Hidradenitis suppurativa (HS) is associated with adverse maternal and obstetric outcomes compared with patients without HS, according to a meta-analysis of five retrospective cohort studies.

The findings, which received “honorable mention” as a poster at the American Academy of Dermatology (AAD) 2026 Annual Meeting, suggest a higher risk for maternal hypertensive disorders, cesarean delivery, and preterm birth among patients with HS but no statistically significant differences for preeclampsia or stillbirth compared with non-HS pregnancies, reported senior author Evardo Barros de Deus Nunes Junior, MD, from the Afya Faculty of Medical Sciences of Pará, Marabá, Brazil, and co-authors.

For the meta-analysis, the researchers searched the PubMed, Embase, and Cochrane databases in May 2025 for studies comparing maternal and fetal outcomes in pregnant women with HS to those without HS. Five retrospective cohort studies were included, comprising a total of 16,761,454 pregnant patients, aged 27.5-29.9 years, of whom 0.0518% had HS.

Random-effects models calculated a pooled odds ratio (OR) of 1.81 for maternal hypertensive disorders, with a 95% CI of 1.49-2.20 (P < .001).

Similarly, increased risk was seen for cesarean delivery (OR, 1.34; 95% CI, 1.09-1.65; P = .006) and preterm birth (OR, 1.20; 95% CI, 1.01-1.43; P = .035).

However, the ORs for preeclampsia (OR, 1.18; 95% CI, 1.00-1.40; P = .057) and stillbirth (OR, 1.08; 95% CI, 0.57-2.06; P = .810) did not reach statistical significance.

Asked to comment on the findings, Akua Sarfo, MD, PhD, medical director for the Hope for HS New England branch and assistant professor of dermatology and assistant director of the Dermatology Research Center at UConn Health in Farmington, Connecticut, said the study is important because “it provides objective data in support of what we tend to see clinically — that this chronic condition, which is most often diagnosed during peak reproductive ages, can be associated with adverse maternal and pregnancy outcomes and higher-risk status.”

Sarfo, who was not involved in the research, added that “those of us who treat women with HS, and particularly those with more clinically severe disease, are aware that in the setting of pregnancy, these patients are almost always considered high risk at baseline.”

This high-risk status stems from multiple factors, she told Medscape Medical News, including the underlying severity of the condition; the disease location, such as the groin, buttocks, or perineum, which may affect decisions about vaginal birth vs cesarean delivery; and HS therapies, such as biologics with immunosuppressive properties that may cross the placenta. Other factors are the propensity for HS to occur with other comorbid conditions that may independently affect risk status, such as depression or anxiety, and metabolic syndrome or type 2 diabetes.

“I typically work closely with my colleagues in Ob/Gyn and maternal-fetal medicine to develop the best interdisciplinary care approach to give these patients the care they need to ensure safe pregnancy and delivery outcomes,” Sarfo added.

The authors declared having no conflicts of interest and no financial support related to this study. Sarfo reported having no relevant disclosures.

Kate Johnson is a Montreal-based freelance medical journalist who has been writing for more than 30 years about all areas of medicine.