Maternal Diabetes during Pregnancy and Risk of Childhood Psoriasis in Offspring: A National Retrospective Cohort Study

Objective Maternal diabetes during pregnancy is associated with long-term metabolic and immune-related outcomes in offspring. While psoriasis is strongly linked to metabolic comorbidities later in life, the impact of in utero exposure to maternal diabetes on psoriasis risk in offspring remains unknown. We investigated whether maternal diabetes during pregnancy is associated with the development of childhood psoriasis in offspring. Research Design and Methods We conducted a retrospective population-based cohort study using electronic health record data from Clalit Health Services, Israel's largest health maintenance organization. The cohort included 215,280 singleton live births between 2010 and 2023, with follow-up through 2024. Maternal diabetes during pregnancy was identified using ICD-10 codes and categorized as gestational diabetes, type 1 diabetes, or type 2 diabetes. The primary outcome was childhood psoriasis in offspring. Multivariable Cox proportional hazards analysis adjusted for maternal, pregnancy, and offspring characteristics were used to estimate associations. Results Overall, 5.4% of offspring were born to mothers with diabetes during pregnancy. During follow-up, 1,557 children (0.7%) were diagnosed with psoriasis. Psoriasis prevalence did not differ between offspring exposed and unexposed to maternal diabetes (0.7% vs. 0.7%). No associations were observed by diabetes subtype, treatment modality, or degree of glycemic control. In adjusted analyses, maternal diabetes was not associated with childhood psoriasis in offspring (HR 1.17, 95% CI 0.90-1.54; p = 0.246). Conclusions Maternal diabetes during pregnancy was not associated with increased childhood psoriasis risk in offspring. Our findings do not support a substantial role for prenatal metabolic dysregulation in childhood psoriasis development.