Perinatal outcome and long-term infectious hospitalizations of offspring born to women with known drug allergy

Assil Mahamid; Tamar Wainstock; Eyal Sheiner; Elli Rosenberg; Dvora Kluwgant; Gali Pariente

doi:10.1111/aji.13608

Perinatal outcome and long-term infectious hospitalizations of offspring born to women with known drug allergy

Am J Reprod Immunol. 2022 Nov;88(5):e13608. doi: 10.1111/aji.13608. Epub 2022 Sep 11.

Authors

Assil Mahamid¹, Tamar Wainstock², Eyal Sheiner³, Elli Rosenberg⁴, Dvora Kluwgant⁵, Gali Pariente²

Affiliations

¹ Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
² Faculty of Health Sciences, Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
³ Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
⁴ Adult Clinical Immunology and Allergy Service, University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
⁵ School of Population and Global Health, University of Melbourne, Melbourne, Ausralia.

PMID: 36006619
DOI: 10.1111/aji.13608

Abstract

Problem: Maternal drug allergy has been associated with altered immune status and an inflammatory environment, which may affect the risk of future infectious diseases in the offspring.

Objectives: We aimed to evaluate perinatal outcomes and long-term infectious hospitalization in the offspring of women with documented drug allergy.

Method of study: The study was conducted at the Soroka University Medical Center (SUMC), a tertiary medical center. For perinatal outcomes, generalized estimation equation (GEE) models were used controlling for maternal age, maternal diabetes mellitus, smoking, and hypertensive disorders. The study groups were followed until 18 years of age for infectious-related hospitalizations. A Kaplan-Meier survival curve was used to compare the cumulative incidence of long-term infectious hospitalizations. A Cox proportional hazards model was conducted to control for confounders.

Results: During the study period, 243 682 deliveries met the inclusion criteria, of which 9756 (4.0%) occurred in women with documented drug allergy. Using GEE, maternal drug allergy was found to be a significant independent risk factor for hypertensive disorders, diabetes mellitus, intra-uterine growth restriction (IUGR), and preterm delivery. Offspring also had significantly higher rates of long-term infectious hospitalizations. Kaplan-Meier survival curves demonstrated significantly higher cumulative incidence rates of infectious hospitalization (log-rank p < .001). In a Cox proportional hazards model, being born to a mother with documented drug allergy was independently associated with infectious hospitalization of the offspring in the long term.

Conclusions: Maternal documented drug allergy is independently associated with an adverse perinatal outcome such as IUGR and preterm delivery and increased risk of long-term infectious hospitalization of the offspring.

Keywords: drug allergy; long-term infectious diseases; maternal drug allergy; perinatal outcomes.

MeSH terms

Diabetes, Gestational*
Drug Hypersensitivity*
Female
Hospitalization
Humans
Hypertension, Pregnancy-Induced*
Incidence
Infant
Infant, Newborn
Pharmaceutical Preparations
Pregnancy
Premature Birth* / epidemiology
Retrospective Studies
Risk Factors

Substances

Pharmaceutical Preparations