Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data

<br><strong>Background: </strong>Anaphylaxis in pregnancy is an understudied, rare, and severe complication of pregnancy.</br> <br><strong>Objective: </strong>To describe the incidence and temporal trends, and to identify potential risk factors for anaphyla...

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Main Authors: McCall, S, Kurinczuk, J, Knight, M
Format: Journal article
Language:English
Published: Elsevier 2019
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author McCall, S
Kurinczuk, J
Knight, M
author_facet McCall, S
Kurinczuk, J
Knight, M
author_sort McCall, S
collection OXFORD
description <br><strong>Background: </strong>Anaphylaxis in pregnancy is an understudied, rare, and severe complication of pregnancy.</br> <br><strong>Objective: </strong>To describe the incidence and temporal trends, and to identify potential risk factors for anaphylaxis-related hospitalizations while pregnant in the United States.</br> <br><strong>Methods: </strong>All hospitalizations while pregnant and any anaphylactic reactions were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes from the National Inpatient Sample, United States, over the period 2004 to 2014. Annual incidence rates of anaphylaxis during pregnancy were calculated. Logistic regression models assessed risk factors for anaphylaxis during pregnancy, presented as odds ratios (ORs) and 95% CIs.</br> <br><strong>Results: </strong>During the period 2004 to 2014, the incidence of anaphylaxis during pregnancy was 3.8 (95% CI, 3.4-4.2) per 100,000 hospitalizations while pregnant. The incidence did not statistically differ during the period 2004 to 2014. After adjustment, there were 3 factors that increased the odds of anaphylaxis during pregnancy: cesarean delivery (adjusted OR [aOR], 4.19; 95% CI, 3.28-5.35) compared with noncesarean delivery; history of an allergic reaction (aOR, 4.05; 95% CI, 2.64-6.23) compared with no history; and a black race (aOR, 1.57; 95% CI, 1.15-2.15) and other race (aOR, 1.69; 95% CI, 1.08-2.63) compared with white race.</br> <br><strong>Conclusions: </strong>Despite increased rates of cesarean delivery in the United States and consequent drug administration, there was no evidence of an increasing trend in anaphylaxis. Cesarean delivery and history of an allergic reaction allow the identification of women at risk of anaphylaxis. Not all women had clear risk factors, and preparations should always be in place to ensure timely management if this uncommon event occurs.</br>
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spelling oxford-uuid:72343bb5-4ff2-4242-9580-9f1211daf08d2022-03-26T19:48:32ZAnaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected dataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:72343bb5-4ff2-4242-9580-9f1211daf08dEnglishSymplectic Elements at OxfordElsevier2019McCall, SKurinczuk, JKnight, M<br><strong>Background: </strong>Anaphylaxis in pregnancy is an understudied, rare, and severe complication of pregnancy.</br> <br><strong>Objective: </strong>To describe the incidence and temporal trends, and to identify potential risk factors for anaphylaxis-related hospitalizations while pregnant in the United States.</br> <br><strong>Methods: </strong>All hospitalizations while pregnant and any anaphylactic reactions were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes from the National Inpatient Sample, United States, over the period 2004 to 2014. Annual incidence rates of anaphylaxis during pregnancy were calculated. Logistic regression models assessed risk factors for anaphylaxis during pregnancy, presented as odds ratios (ORs) and 95% CIs.</br> <br><strong>Results: </strong>During the period 2004 to 2014, the incidence of anaphylaxis during pregnancy was 3.8 (95% CI, 3.4-4.2) per 100,000 hospitalizations while pregnant. The incidence did not statistically differ during the period 2004 to 2014. After adjustment, there were 3 factors that increased the odds of anaphylaxis during pregnancy: cesarean delivery (adjusted OR [aOR], 4.19; 95% CI, 3.28-5.35) compared with noncesarean delivery; history of an allergic reaction (aOR, 4.05; 95% CI, 2.64-6.23) compared with no history; and a black race (aOR, 1.57; 95% CI, 1.15-2.15) and other race (aOR, 1.69; 95% CI, 1.08-2.63) compared with white race.</br> <br><strong>Conclusions: </strong>Despite increased rates of cesarean delivery in the United States and consequent drug administration, there was no evidence of an increasing trend in anaphylaxis. Cesarean delivery and history of an allergic reaction allow the identification of women at risk of anaphylaxis. Not all women had clear risk factors, and preparations should always be in place to ensure timely management if this uncommon event occurs.</br>
spellingShingle McCall, S
Kurinczuk, J
Knight, M
Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data
title Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data
title_full Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data
title_fullStr Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data
title_full_unstemmed Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data
title_short Anaphylaxis in pregnancy in the USA: Risk factors and temporal trends using national routinely collected data
title_sort anaphylaxis in pregnancy in the usa risk factors and temporal trends using national routinely collected data
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AT kurinczukj anaphylaxisinpregnancyintheusariskfactorsandtemporaltrendsusingnationalroutinelycollecteddata
AT knightm anaphylaxisinpregnancyintheusariskfactorsandtemporaltrendsusingnationalroutinelycollecteddata