title: Maternal and fetal outcome in Swedish women with erythropoietic protoporphyria.
abstract: BACKGROUND
  Painful photosensitivity is characteristic of erythropoietic protoporphyria (EPP). In women, symptoms may be affected by menstrual cycle and pregnancy but very little is known about maternal and fetal outcome.
  
  
  OBJECTIVE
  To investigate the impact of menstruation, pregnancy and breast-feeding on photosensitivity and possible effects of EPP on maternal, fetal and neonatal outcome.
  
  
  METHODS
  Retrospective study screening all 20 Swedish women alive and older than 18 years diagnosed with EPP with a total of 33 deliveries. Data were retrieved for 19 women and 32 deliveries in medical records and completed by a questionnaire sent to the patients.
  
  
  RESULTS
  Photosensitivity worsened in five of 19 (26%) women around menstruation whereas amelioration was reported in 17 of 32 (53%) pregnancies and during 11 of 32 (34%) breast-feeding periods. Fertility rate was normal and there were no maternal or fetal complications apart from minor arterial hypertension in one woman.
  
  
  CONCLUSIONS
  The study confirms changes in photosensitivity during menstruation and pregnancy. Amelioration during breast-feeding is a new finding. Pregnancy appears safe without increased risks of pregnancy complications or adverse effects on fetal or neonatal health.
authors.affiliation: Department of Gastroenterology and Hepatology, K63, Karolinska Institutet, Karolinska University Hospital, Huddinge, SE-141 86, Stockholm, Sweden. staffan.wahlin@karolinska.se
authors.forename: S
authors.initials: S
authors.lastname: Wahlin
authors.forename: H-U
authors.initials: HU
authors.lastname: Marschall
authors.forename: B
authors.initials: B
authors.lastname: Fischler
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008429:Maternal Welfare; D008598:Menstruation / Q000502:physiology; D010787:Photosensitivity Disorders / Q000209:etiology / Q000378:metabolism; D011166:Porphyrins / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D046351:Protoporphyria, Erythropoietic / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D013472:Sunlight / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013548:Sweden; D044465:White People; D055815:Young Adult
chemical_list: D011166:Porphyrins