The correct answer is A. Increased risk of prematurity and small-for-gestational age.

Increased risk of prematurity and small-for-gestational age. The rash demonstrated in the picture is pemphigoid gestationis. Approximately 10% of newborns develop mild skin involvement due to passive transfer of maternal antibodies and this resolves spontaneously within days to weeks. There seems to be an increased risk of prematurity and small-for-gestational age neonates, presumably due to chronic placental insufficiency. Recently, it was shown that this risk correlates with disease severity, i.e. occurrence of blistering and early onset, and not with the use of systemic corticosteroids.

Atopic eruption of pregnancy and polymorphic eruption of pregnancy both do not have any associated fetal risks.1 Intrahepatic cholestasis of pregnancy is associated with significant fetal risk, in particular an increase in premature births (20–60%), intrapartum fetal distress (20–30%; e.g. meconium staining of amniotic fluid, abnormal fetal heart rate), and fetal loss (1–2%). Fetal risk correlates with the elevation in serum bile acid levels, especially when levels exceed 40 µmol/l.

References:

1. Bolognia JL, Schaffer JV, Cerroni L, Callen JP. Dermatology Volume 2. Edinburgh Elsevier; 2018.

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