Infants Born to Mothers with Alopecia Areata at Increased Risk of Adverse Outcomes

Infants born to mothers with alopecia areata are at an increased risk of developing birth comorbidities, according to recent findings, though the causal association will require additional research.1

These findings were the result of an analysis of nationwide data in South Korea, with investigators assessing any links between maternal alopecia areata and their offspring’s risk of adverse birth outcomes. The research team for this analysis was led by Jung-Won Shin, from the department of dermatology at Seoul National University Bundang Hospital.

Shin and colleagues highlighted the fact that while prior data on systemic autoimmune or inflammatory conditions have indicated that the course of pregnancies can be impacted by such diseases, they noted the lack of data on neonatal outcomes in maternal alopecia.2

“Our study aimed to determine the association between maternal [alopecia areata] and birth outcomes of offspring, including preterm delivery, [low birth weight], delivery by Caesarean section, and congenital malformations, using the Korean National Health Insurance (NHI) claims database,” Shin and colleagues wrote.1

Trial Design Details

The investigative team examined this association through an assessment of retrospective data from the Korean National Health Insurance (NHI) database, a database connected to the country’s National Health Screening Program for Infants and Children (NHSIC). Currently, the NHSIC program has a coverage rate of approximately 80% of children in Korea, and the NHI is known to cover more than 50 million individuals.

Childrens’ growth and development are tracked through the NHSIC in Korea, and children in this program were deemed eligible to take part in this program up to 7 times between the ages of 4 - 71 months. NHSIC-associated clinicians assess different aspects of a child's health and birth-related data on gestational age, mode of delivery, birth weight, and feeding habits, such as breastfeeding. Such evaluations then report their data to the NHI.

For the retrospective assessment of available data, the investigators’ study population included all live singleton births that were recorded in Korea between January 2002 - December 2016, totaling 4,804,806 infants. Among these children, the research team noted that 45,328 were born to mothers given an alopecia diagnosis before delivery, while 56,225 were born to ones diagnosed with the skin condition following delivery.

The team specifically sought to examine the effect of maternal alopecia areata on birth outcomes during pregnancy, so they did not include infants born to mothers diagnosed with the condition after delivery, leaving 4,703,253 infants with mothers that did not have alopecia and would function as the control arm.

The researchers determined the primary birth outcome that they would assess in their research would include such outcomes as low birth weight (LBW), preterm birth, cesarean section delivery, and various types of congenital malformations. For the purposes of evaluating these outcomes, they used multivariate logistic regression analyses.

Notable Findings

The investigators concluded that significantly increased risk was observed among children with mothers diagnosed with alopecia areata, compared to the results of those in the control cohort. Specifically, the investigative team noted higher risk among infants of low birth weight (OR 1.36, 95% CI 1.30–1.42; aOR 1.11, 95% CI 1.05–1.17), preterm birth (OR 1.39, 95% confidence interval [CI] 1.33–1.45; adjusted OR [aOR] 1.07, 95% CI 1.01–1.13), and cesarean section delivery (OR 1.24, 95% CI 1.22–1.26; aOR 1.12, 95% CI 1.08–1.15).

Additionally, the research team reported that offspring of mothers with the skin condition were shown to have a greater likelihood of developing different types of congenital malformations (OR 1.19, 95% CI 1.15–1.22; aOR 1.10, 95% CI 1.07–1.14). The team highlighted the particularly increased malformation risk in infants’ musculoskeletal systems (OR 1.19, 95% CI 1.12–1.27; aOR 1.12, 95% CI 1.05–1.19) and urinary systems (OR 1.33, 95% CI 1.19–1.48; aOR 1.16, 95% CI 1.04–1.29).

“In conclusion, infants born to mothers with [alopecia areata] had an increased risk of birth comorbidities,” they wrote. “Further investigation is required to clarify the causal association between maternal [alopecia areata] and these comorbidities in off-spring.”1

References

1. Shin, J.-W., Kang, T., Swan, H., Paik, K., Huh, C.-H., & Kim, H. J. (2025). Birth Outcomes of Infants Born to Mothers with Alopecia Areata: A Nationwide Population-based Study in Korea. Acta Dermato-Venereologica, 105, adv42248. https://doi.org/10.2340/actadv.v105.42248.
2. Costedoat-Chalumeau N, Amoura Z, Lupoglazoff JM, Huong DL, Denjoy I, Vauthier D, et al. Outcome of pregnancies in patients with anti-SSA/Ro antibodies: a study of 165 pregnancies, with special focus on electrocardiographic variations in the children and comparison with a control group. Arthritis Rheum 2004; 50: 3187–3194. https://doi.org/10.1002/art.20554.