Obstetrics & Gynecology, 5620 Jewish General Hospital, McGill University , Montreal, Quebec, Canada.
Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, Quebec, Canada.
J Perinat Med. 2024 Aug 20;52(8):870-877. doi: 10.1515/jpm-2023-0310. Print 2024 Oct 28.
Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that affects the peripheral nervous system. The purpose of our study was to evaluate maternal and fetal/neonatal outcomes among pregnancies complicated by GBS.
We performed a retrospective cohort study using the Healthcare Cost and Utilization Project - National Inpatient Sample from the United States. ICD-9 codes were used to identify all pregnant women who delivered between 1999 and 2015 and had a diagnosis of GBS. The remaining women without GBS who delivered during that time period constituted the comparison group. The associations between maternal GBS and obstetrical and fetal/neonatal outcomes were evaluated using multivariate logistic regression, while adjusting for the confounding effects of maternal characteristics.
Of 13,792,544 births included in our study, 291 were to women with GBS, for an overall incidence of 2.1/100,000 births. A steady increase in maternal GBS was observed over the study period (from 1.26 to 3.8/100,000 births, p0.02). Further, women with GBS were more likely to have pregnancies complicated by preeclampsia, OR 1.69 (95 % CI 1.06-2.69), sepsis, 9.30 (2.33-37.17), postpartum hemorrhage, 1.83 (1.07-3.14), and to require a transfusion, 4.39 (2.39-8.05). They were also at greater risk of caesarean delivery, 2.07 (1.58-2.72) and increased length of hospital stay, 4.48 (3.00-6.69). Newborns of women with GBS were more likely to be growth restricted, 2.50 (1.48-4.23).
GBS in pregnancy is associated with maternal and newborn adverse outcomes. These patients would benefit from close follow-up throughout their pregnancy and in the postpartum period.
格林-巴利综合征（GBS）是一种罕见的自身免疫性疾病，影响外周神经系统。本研究旨在评估妊娠合并 GBS 患者的母婴/新生儿结局。
我们使用美国医疗保健成本和利用项目-国家住院样本进行了回顾性队列研究。使用 ICD-9 代码识别 1999 年至 2015 年间分娩且诊断为 GBS 的所有孕妇。在此期间分娩且无 GBS 的其余女性构成对照组。使用多变量逻辑回归评估母体 GBS 与产科和母婴/新生儿结局之间的关联，同时调整母体特征的混杂效应。
在我们的研究中，纳入了 13792544 例分娩，其中 291 例为 GBS 孕妇，总发生率为 2.1/100000 分娩。在研究期间，母体 GBS 呈稳步上升趋势（从 1.26 至 3.8/100000 分娩，p0.02）。此外，患有 GBS 的孕妇更有可能并发子痫前期，OR 1.69（95%CI 1.06-2.69）、败血症，9.30（2.33-37.17）、产后出血，1.83（1.07-3.14）和需要输血，4.39（2.39-8.05）。她们也更有可能进行剖宫产，2.07（1.58-2.72）和延长住院时间，4.48（3.00-6.69）。患有 GBS 的孕妇的新生儿更有可能生长受限，2.50（1.48-4.23）。
妊娠合并 GBS 与母婴不良结局相关。这些患者在整个妊娠和产后期间都将受益于密切随访。
