Pruritic Urticarial Papules and Plaques of Pregnancy Are Not Related to Maternal or Fetal Weight Gain

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To the Editor.— We read the recent article by Cohen et al1 with interest describing the possible relationship between maternal or fetal weight gain, twin pregnancy, and pruritic urticarial papules and plaques of pregnancy (PUPPP). They suppose that abdominal distention or a reaction to it may play a role in the genesis of the PUPPP. We have seen 22 cases of PUPPP between January 11, 1988, and March 10,1989, at the hospital of the University of Tours (France). Two of the patients were twin gestations. All of these PUPPP have had a negative direct immunofluorescence on skin biopsy. During this period there were 3192 deliveries. An age- and parity-matched control of 20 women was selected among outpatient pregnant women without pruritus who were seen at the same time in our hospital. Statistical evaluation by paired Student's t test was performed for maternal weight gain in pregnancy and for newborn birth

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