Research Article
Prevalence and Relevance of Pruritus in Pregnancy
Justyna Szczwch,
1,2
Artur Wiatrowski,
3
Lidia Hirnle,
4
and Adam Reich
1,2
1
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
2
Department of Dermatology, University of Rzesz´ ow, Rzesz´ ow, Poland
3
1st Department and Clinic of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
4
2nd Department and Clinic of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
Correspondence should be addressed to Adam Reich; adam.reich@umed.wroc.pl
Received 27 April 2017; Revised 13 August 2017; Accepted 23 August 2017; Published 25 September 2017
Academic Editor: Vinod Chandran
Copyright © 2017 Justyna Szczęch et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Pregnant women are at greater risk to sufer from chronic pruritus, but data on this symptom in this group is very limited. Te aim of
this study was to investigate the prevalence, clinical characteristics, and the importance of pruritus in pregnant women. A total of 292
consecutive pregnant women at the 33.0 ± 6.1 weeks of gestation (WoG) were recruited into this prospective, cross-sectional study.
All patients underwent thorough anamnesis and detailed physical examination with the special emphasis on pruritus. Pruritus was
assessed according to Visual Analogue Scale (VAS). Quality of life was measured with the Dermatology Life Quality Index (DLQI).
Te point prevalence of pruritus was 20.2% ( = 59), while pruritus prevalence during the entire pregnancy was 38.0% ( = 111).
Pruritus started on average at the 27.2 ± 7.6 WoG; it was signifcantly more common among women in third trimester. Te mean
VAS was 4.8 (±2.4) points. Te DLQI scoring signifcantly correlated with VAS ( = 0.52, < 0.001). Based on the results of our
study about one-third of women sufer from pruritus during pregnancy. Many of them fnd it a very distressing and disturbing
symptom.
1. Introduction
Data on pruritus in pregnancy is rather limited, and physi-
cians treating pregnant women may underestimate its fre-
quency and clinical meaningfulness. Most published papers
concerning this symptom during pregnancy focused mainly
on itch occurring in intrahepatic cholestasis of pregnancy
(ICP) and other pregnancy-specifc dermatoses, leaving the
problem of idiopathic itch in pregnant women without proper
investigation.
Pregnancy is a state that leads to various hormonal, meta-
bolic, and immunologic changes, which may infuence the
functioning and structure of the skin and mucous mem-
branes. Almost 90% of the pregnant women will present
with the signs of hyperpigmentation, mainly visible in phys-
iologically highly pigmented areas, for example, genitals,
perineum, periumbilical skin, and areolae [1, 2]. Equally
ofen, on the abdomen may occur the striae gravidarum, or
“stretch marks,” which are the result of skin stretching com-
bined with genetic and hormonal changes [1, 3]. In nearly
75% of pregnancy cases physicians will observe gray-brown
patches located on the face, previously termed as “mask
of pregnancy,” namely, melasma [1]. Besides the above
described skin changes pregnant women also present with
some physiological hair, nail, and vascular changes, which
need to be diferentiated from pathological symptoms to
avoid unnecessary treatment [1]. Moreover, there is a group of
specifc dermatoses of pregnancy, in which we can distinguish
atopic eruption of pregnancy (AEP), polymorphic eruption
of pregnancy (PEP), pemphigoid gestationis (PG), and ICP
[4]. Te endocrinology of pregnancy involves increased ac-
tivity of maternal adrenal and pituitary glands, along with
physiological development of fetal endocrine glands. Proges-
terone and estrogen, among other hormones (e.g., increased
cortisone levels), are major factors infuencing skin during
pregnancy [5]. It is possible that these changes may alter
the pruritus pathway and contribute to itch in susceptible
individuals [6].
In 2007, the International Forum for the Study of Itch
(IFSI) established a new classifcation of chronic itch which
allows physicians to assign all patients with pruritus to
one of three groups including subjects with pruritus on
Hindawi
BioMed Research International
Volume 2017, Article ID 4238139, 6 pages
https://doi.org/10.1155/2017/4238139