The journal of allergy and clinical immunology. In practice · 2026
The Relationship Between Maternal Nonnarcotic Analgesics Allergy Labels and Maternal and Fetal Outcomes: Results From a Large Administrative Cohort.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Su Chang, Baer Rebecca J, Schatz Michael, Chambers Christina
Аннотация
BACKGROUND: Nonnarcotic analgesics are the recommended first-line treatment for postpartum pain, and low-dose aspirin is recommended in approximately 85% of pregnant patients who have preeclampsia risk factors. Timely evaluation of nonnarcotic analgesics allergy labels (NNAALs) is essential for high-quality perinatal care.
OBJECTIVE: To address a knowledge gap in the relationship between maternal NNAALs and maternal and fetal outcomes.
METHODS: A retrospective analysis was conducted using the Study of Outcomes in Mothers and Infants, a population-based cohort of all births in California between 2016 and 2021. Maternal and fetal outcomes were examined by NNAAL status using Poisson log-linear regression to calculate adjusted relative risks (aRRs), 95% confidence intervals (CIs), and P values adjusted for maternal characteristics.
RESULTS: Maternal NNAALs were significantly associated with increased rates of preeclampsia (aRR, 1.16; P < .0001) and eclampsia (aRR, 1.64; P = .0047), cesarean delivery (aRR, 1.2; P < .0001), preterm birth (aRR, 1.17; P < .0001), infants with neonatal intensive care unit admission (aRR, 1.09; P = .0076), neonatal opioid withdrawal syndrome (aRR, 1.49; P < .0001), infant long length of hospital stay (aRR, 1.16; P < .0001), and a decreased rate of infants large for gestational age (aRR, 0.92; P = .0092), but were not associated with infants small for gestational age, major structural birth defects, or 5-minute Apgar score less than 7.
CONCLUSIONS: Maternal NNAALs were significantly associated with various maternal and fetal adverse outcomes. Our data suggest that proactive evaluations of patients with NNAALs may improve perinatal outcomes.
OBJECTIVE: To address a knowledge gap in the relationship between maternal NNAALs and maternal and fetal outcomes.
METHODS: A retrospective analysis was conducted using the Study of Outcomes in Mothers and Infants, a population-based cohort of all births in California between 2016 and 2021. Maternal and fetal outcomes were examined by NNAAL status using Poisson log-linear regression to calculate adjusted relative risks (aRRs), 95% confidence intervals (CIs), and P values adjusted for maternal characteristics.
RESULTS: Maternal NNAALs were significantly associated with increased rates of preeclampsia (aRR, 1.16; P < .0001) and eclampsia (aRR, 1.64; P = .0047), cesarean delivery (aRR, 1.2; P < .0001), preterm birth (aRR, 1.17; P < .0001), infants with neonatal intensive care unit admission (aRR, 1.09; P = .0076), neonatal opioid withdrawal syndrome (aRR, 1.49; P < .0001), infant long length of hospital stay (aRR, 1.16; P < .0001), and a decreased rate of infants large for gestational age (aRR, 0.92; P = .0092), but were not associated with infants small for gestational age, major structural birth defects, or 5-minute Apgar score less than 7.
CONCLUSIONS: Maternal NNAALs were significantly associated with various maternal and fetal adverse outcomes. Our data suggest that proactive evaluations of patients with NNAALs may improve perinatal outcomes.