title: Pregnancy outcome of patients with pruritic urticarial papules and plaques of pregnancy.
abstract: OBJECTIVE
  The study was designed to investigate obstetric risk factors and pregnancy outcome of patients with pruritic urticarial papules and plaques of pregnancy (PUPPP).
  
  
  METHODS
  A population-based study comparing all pregnancies of women with and without PUPPP was conducted. Deliveries occurred during the years 1988-2002 at the Soroka University Medical Center. A multivariable logistic regression model was constructed in order to find independent risk factors associated with PUPPP.
  
  
  RESULTS
  During a 15-year period, 159 197 deliveries took place. PUPPP complicated 42 (0.03%) of all pregnancies. Using a multivariable analysis, the following conditions were significantly associated with PUPPP: multiple pregnancies (odds ratio (OR) = 4.9, 95% confidence interval (CI) 1.7-14.1), hypertensive disorders (OR = 2.2, 95% CI 1.1-4.7), and induction of labor (OR = 7.6, 95% CI 4.0-14.5). Higher rates of 5-minute Apgar scores lower than 7 (OR = 8.0, 95% CI 4.4-14.9) and of cesarean deliveries (OR = 2.9, 95% CI 1.5-5.6) were noted in the PUPPP as compared to the comparison group. While investigating other perinatal outcome parameters such as oligohydramnios, intrauterine growth restriction, meconium-stained amniotic fluid and perinatal mortality, no significant differences were observed between the groups.
  
  
  CONCLUSIONS
  Pruritic urticarial papules and plaques of pregnancy is a condition significantly associated with multiple pregnancies, hypertensive disorders, and induction of labor. Perinatal outcome is comparable to pregnancies without PUPPP.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er-Sheva, Israel. ohel@bgu.ac.il
authors.forename: Iris
authors.initials: I
authors.lastname: Ohel
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
authors.forename: Tali
authors.initials: T
authors.lastname: Silberstein
authors.forename: Gershon
authors.initials: G
authors.lastname: Holcberg
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications; D007231:Infant, Newborn; D016015:Logistic Models; D008470:Meconium; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D016104:Oligohydramnios / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011537:Pruritus / Q000150:complications*; D012307:Risk Factors; D014581:Urticaria / Q000150:complications*