Anaphylaxis in Pregnancy

Key points

  • Anaphylaxis in pregnancy is a very rare complication; collection of information on a multi-national basis will allow for more robust research, including assessment of risk factors.
  • Policy differences between countries, for example concerning prophylactic antibiotic usage, may be associated with different incidences of anaphylaxis in pregnancy.
  • International studies will provide better estimates of pregnancy outcomes for both mother and child.

Surveillance period

September 2016 – March 2018

Introduction

Anaphylaxis in pregnancy is a potentially fatal systemic hypersensitivity reaction, which is rapid in onset. It is characterised by a life-threatening airway, breathing or circulatory problems often with skin or mucosal change. Outcomes of anaphylaxis in pregnancy are very serious, as described in case reports of maternal and neonatal mortality (Cooper et al., 2005, Berenguer et al., 2013).

Exposure to antibiotics is increasing in the pregnant population through the use of prophylactic antibiotics before caesarean section and for treatment of group B streptococcal carriage to prevent neonatal transmission (Sengupta and Kohli, 2008, Khan et al., 2008). As a result, it is important to assess the causative factors of anaphylaxis in pregnancy and whether this increased antibiotic usage is associated with an increased incidence of anaphylaxis in pregnancy.

Methods

Cases have been identified in the UK through UKOSS.

Cases are currently being prospectively identified in Belgium and France. Data are collected through an online portal

Access reporting system

OpenClinca guide for reporters

Direct link to MP4

Time points in the video.

Welcome and login: 00:00-00:30 seconds
Accessing the case: 00:30- 02:00
Simple data entry: 02.00 - 03.00
Missing information:  04.00 – 05.20
Data queries: 06:10 – 07.15
Quick save: 07.16 – 08:02
Completing data entry form: 10.00

Study contact

NPEU contacts:

Stephen McCall (stephen.mccall@npeu.ox.ac.uk)
Professor Marian Knight (marian.knight@npeu.ox.ac.uk)
Jenny Kurinczuk (jenny.kurinczuk@npeu.ox.ac.uk)

Belgium: Dr Griet Vandenberghe (Griet.Vandenberghe@uzgent.be)
France: Dr Marie-Pierre Bonnet (bonnet.mpierre@gmail.com)
Netherlands: Dr Timme Schaap (info@nethoss.nl)

References

BERENGUER, A., COUTO, A., BRITES, V. & FERNANDES, R. 2013. Anaphylaxis in pregnancy: a rare cause of neonatal mortality. BMJ Case Reports, 2013.

COOPER, G. M., MCCLURE, J. H. & BOARD, O. B. O. T. E. 2005. Maternal deaths from anaesthesia. An extract from Why Mothers Die 2000–2002, the Confidential Enquiries into Maternal Deaths in the United Kingdom: Chapter 9: Anaesthesia. British Journal of Anaesthesia, 94, 417-423.

KHAN, R., ANASTASAKIS, E. & KADIR, R. A. 2008. Anaphylactic reaction to ceftriaxone in labour. An emerging complication. Journal of Obstetrics and Gynaecology, 28, 751-753.

SENGUPTA, A. & KOHLI, J. K. 2008. Antibiotic prophylaxis in cesarean section causing anaphylaxis and intrauterine fetal death. Journal of Obstetrics and Gynaecology Research, 34, 252-254.