National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK.
Center for Research on Population and Health, American University of Beirut, Lebanon.
Anaesthesia. 2020 Nov;75(11):1469-1475. doi: 10.1111/anae.15069. Epub 2020 May 28.
Anaphylaxis in pregnancy is a rare but severe complication for both mother and infant. Population-based data on anaphylaxis in pregnancy are lacking from mainland European countries. This multinational study presents the incidence, causative agents, management and maternal and infant outcomes of anaphylaxis in pregnancy. This descriptive multinational study used a combination of retrospective (Finnish medical registries) and prospective population-based studies (UK, France, Belgium and the Netherlands) to identify cases of anaphylaxis. Sixty-five cases were identified among 4,446,120 maternities (1.5 per 100,000 maternities; 95%CI 1.1-1.9). The incidence did not vary between countries. Approximately three-quarters of reactions occurred at the time of delivery. The most common causes were antibiotics in 27 women (43%), and anaesthetic agents in 11 women (17%; including neuromuscular blocking drugs, 7), which varied between countries. Anaphylaxis had very poor outcomes for one in seven mothers and one in seven babies; the maternal case fatality rate was 3.2% (95%CI 0.4-11.0) and the neonatal encephalopathy rate was 14.3% (95%CI 4.8-30.3). Across Europe, anaphylaxis related to pregnancy is rare despite having a multitude of causative agents and different antibiotic prophylaxis protocols.
妊娠期间的过敏反应是母亲和婴儿都罕见但严重的并发症。欧洲大陆国家缺乏妊娠过敏反应的基于人群的数据。这项多国家研究介绍了妊娠期间过敏反应的发生率、病因、管理以及母婴结局。这项描述性多国家研究结合了回顾性（芬兰医疗登记）和前瞻性基于人群的研究（英国、法国、比利时和荷兰）来识别过敏反应病例。在 4446120 例分娩中发现了 65 例（每 100000 例分娩中有 1.5 例；95%CI 1.1-1.9）。各国之间的发生率没有差异。大约四分之三的反应发生在分娩时。最常见的病因是 27 名妇女（43%）使用抗生素，11 名妇女（17%；包括 7 名神经肌肉阻滞剂）使用麻醉剂，病因因国家而异。有七分之一的母亲和七分之一的婴儿发生了非常严重的过敏反应；母体死亡率为 3.2%（95%CI 0.4-11.0），新生儿脑病发生率为 14.3%（95%CI 4.8-30.3）。在整个欧洲，尽管有多种病因和不同的抗生素预防方案，但与妊娠相关的过敏反应仍然罕见。
