Females, Pregnancy & Chronic Urticaria: What Doctors Should Know

In this episode, Dr. Sophia Neisinger welcomes Prof. Emek Kocatürk, leading urticaria researcher and UCARE expert from Istanbul, to explore the gender-specific aspects of chronic urticaria, with a special focus on pregnancy. 

They discuss: 

🔹 Why do more women than men suffer from chronic urticaria? 
🔹 How does pregnancy affect urticaria symptoms and treatment response? 
🔹 What medications are safe during pregnancy and breastfeeding? 
🔹 How should physicians approach treatment decisions with female patients? 

Prof. Kocatürk shares key insights from the PREG-CU study, involving over 300 pregnant CSU patients, and explains why half of them improve during pregnancy. She outlines practical treatment guidelines for antihistamines and omalizumab use during pregnancy and breastfeeding, discusses estrogen’s inflammatory role, and gives tips for shared decision-making in clinical care. 

Join us for an important and empowering episode that sheds light on female-specific urticaria challenges and how to manage them with evidence-based confidence.

Key Learnings from the Episode 

70% of CSU patients are female, pointing to hormonal and autoimmune factors in disease susceptibility. 

Female CSU patients suffer more: more angioedema, systemic symptoms, worse disease control, and more comorbidities like asthma, thyroid disease, and depression. 

The PREG-CU study showed that 50% of CSU patients improve during pregnancy, offering hope to women planning to conceive. 

Exacerbations during pregnancy are common and linked to worse pregnancy outcomes if untreated. 

Antihistamines (especially cetirizine, loratadine) are safe in pregnancy; second-generation agents are preferred. 

Omalizumab is safe in pregnancy and lactation, particularly starting in the second trimester. 

Antihistamines can be safely continued and even up-dosed during breastfeeding. 

Keeping CSU under control during and after pregnancy is essential for maternal well-being and newborn bonding. 

Shared decision-making and good counseling reduce fear and improve patient experience. 

Digital tools, registries like CURE and CARE, and collaborative research are key to improving care for women with urticaria. 

Chapters 

00:00 Understanding Chronic Urticaria: A Female Predominance 

06:20 Pregnancy and Chronic Urticaria: What to Expect 

11:36 Managing Urticaria During Pregnancy and Lactation 

17:18 Fun Facts and Closing Thoughts

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