Multiparous women with hereditary angioedema (HAE) experience similar outcomes in terms of region and frequency of attacks as do primiparous women, according to the results of an observational, cross-sectional study published in the Journal of Cosmetic Dermatology.

Recognizing that the impact of HAE on childbearing in the multiparous population remains unclear, the researchers sought to explore the clinical course of the disease and the effects of multiparity on patient outcomes. Their aim was to establish the frequency and location of HAE attacks during pregnancy, as well as the efficacy and safety of plasma-derived C1-INH replacement therapy.

During pregnancy, key concerns for women with HAE include hormonal fluctuations and drug safety. Pregnancy can affect the progression of HAE and potential treatment options.

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The present study took place between October 2018 and August 2019 in Turkey. Fifteen multiparous women with HAE participated, with a total of 88 pregnancies evaluated via a questionnaire and the participant’s medical records. The median age of the women was 36 years (range, 33-39 years).

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Of the 88 pregnancies, 72 resulted in healthy babies without any congenital abnormalities, 12 ended in spontaneous abortion, 3 resulted in stillbirth, and 1 neonatal death was reported.

Two-thirds (10 of 15) of the women reported a worsening in the frequency of angioedema attacks during their pregnancies; however, no statistically significant difference was observed compared with the nonpregnant period
(P =.283). One-fifth (3 of 15) of the patients reported alleviation in their attacks during pregnancy.

Although most deliveries were vaginal (57 babies), 19 deliveries in 6 women were by cesarean section. None of the patients was aware of her HAE diagnosis prior to her first pregnancy. Following their HAE diagnosis, 8 patients were treated with 263 vials of plasma-derived C1-INH, with no adverse events reported.

The authors concluded with the following: “Because our study and the existing literature provided only a few examples, more research is needed to determine [the impact of multiparity in HAE]. We believe this would be a fruitful area for further work.”


Karabiber E, Kendirlinan R, Çerçi P. Clinical outcomes of hereditary angioedema on multiparous women. J Cosmet Dermatol. Published online October 7, 2022. doi:10.1111/jocd.15438