Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA.
Ann Allergy Asthma Immunol. 2010 Jan;104(1):55-9. doi: 10.1016/j.anai.2009.11.005.
Previous reports of anaphylaxis during pregnancy typically have involved single institutions and a few cases.
To describe the epidemiologic features of anaphylaxis in women who gave birth in Texas.
Statewide public use hospital discharge data for 2004 and 2005 provided by the Texas Department of State Health Services were accessed. Diagnoses and procedures in this data set were recorded using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The records of women who delivered a neonate and simultaneously had a diagnosis of anaphylaxis were selected for study. The prevalence of maternal anaphylaxis noted at the time of delivery of the neonate and the 95% Wilson's confidence interval were calculated. The International Classification of Diseases, Ninth Revision, Clinical Modification E codes were examined to determine the possible anaphylactic trigger. Finally, the impact of 4 selected maternal comorbidities and complications on length of stay was assessed.
A total of 19 maternal anaphylaxis cases were identified. The prevalence was 2.7 cases per 100,000 deliveries (95% confidence interval, 1.7-4.2 cases per 100,000 deliveries). Penicillins and cephalosporins were the anaphylactic trigger in 11 of the patients. Five patients were emergent admissions. There were no maternal deaths. Most of the patients (14 [74%]) delivered by cesarean section. Patients who had 1 or more of 4 selected comorbidities or complications had a median length of stay of 5 days, whereas those patients free of these conditions had a median length of stay of 3 days (P = .07, exact Wilcoxon rank sum test).
Anaphylaxis during pregnancy is a rare event. In this large case series, we found that beta-lactam antibiotics were the most common triggers of anaphylaxis.
之前关于孕妇过敏反应的报告通常涉及单个机构和少数病例。
描述在德克萨斯州分娩的妇女中过敏反应的流行病学特征。
我们查阅了德克萨斯州卫生部提供的 2004 年和 2005 年全州公共使用医院出院数据。该数据集的诊断和程序是使用国际疾病分类，第九修订版，临床修正码记录的。选择同时有过敏反应诊断的分娩妇女的记录进行研究。计算了新生儿分娩时产妇过敏反应的发生率及其 95%威尔逊置信区间。检查了国际疾病分类，第九修订版，临床修正 E 码以确定可能的过敏触发。最后，评估了 4 种选定的产妇合并症和并发症对住院时间的影响。
共发现 19 例产妇过敏反应病例。发生率为每 100,000 次分娩 2.7 例（95%置信区间，每 100,000 次分娩 1.7-4.2 例）。青霉素类和头孢菌素类是 11 例患者的过敏触发因素。5 例患者为紧急入院。没有产妇死亡。大多数患者（14 [74%]）行剖宫产分娩。患有 4 种选定合并症或并发症中的 1 种或多种的患者的中位住院时间为 5 天，而无这些情况的患者的中位住院时间为 3 天（P =.07，确切的 Wilcoxon 秩和检验）。
孕妇过敏反应是一种罕见事件。在这个大型病例系列中，我们发现β-内酰胺类抗生素是过敏反应最常见的诱因。
