Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS. (April 2019)

• Record Type: Journal Article
• Authors: Lavie, Caroline; Rollot, Fabien; Durand-Dubief, Françoise; Marignier, Romain; Ionescu, Iuliana; Casey, Romain; Moreau, Thibault; Tourniaire, Patricia; Hutchinson, Michael; D'Hooghe, Marie Béatrice; Laplaud, David-Axel; Clavelou, Pierre; De Sèze, Jérôme; Debouverie, Marc; Brassat, David; Pelletier, Jean; Lebrun-Frenay, Christine; Le Page, Emmanuelle; Castelnovo, Giovanni; Berger, Eric; Hautecoeur, Patrick; Heinzlef, Olivier; Durelli, Luca; Clerico, Marinella; Trojano, Maria; Patti, Francesco; Vukusic, Sandra
• Other Names: Alpérovitch A. non-byline-author.; Carton H. non-byline-author.; d'Hooghe M.B. non-byline-author.; Hommes O. non-byline-author.; Hutchinson M. non-byline-author.; Adeleine P. non-byline-author.; Biron A. non-byline-author.; Cortinovis-Tourniaire P. non-byline-author.; Grimaud J. non-byline-author.; Hours M. non-byline-author.; Moreau T. non-byline-author.; Vukusic S. non-byline-author.; Confavreux C. non-byline-author.; Chauplannaz G. non-byline-author.; Confavreux C. non-byline-author.; Cortinovis-Tourniaire P. non-byline-author.; Grimaud J. non-byline-author.; Latombe D. non-byline-author.; Moreau T. non-byline-author.; Clanet M. non-byline-author.; Lau G. non-byline-author.; Rumbach L. non-byline-author.; Goas J.Y. non-byline-author.; Rouhart F. non-byline-author.; Mazingue A. non-byline-author.; Roullet E. non-byline-author.; Madigand M. non-byline-author.; Hautecoeur P. non-byline-author.; Brunet P. non-byline-author.; Edan G. non-byline-author.; Allaire C. non-byline-author.; Riffault G. non-byline-author.; Leche J. non-byline-author.; Benoit T. non-byline-author.; Simonin C. non-byline-author.; Ziegler F. non-byline-author.; Baron J.C. non-byline-author.; Rivrain Y. non-byline-author.; Dumas R. non-byline-author.; Loche D. non-byline-author.; Bourrin J.C. non-byline-author.; Huttin B. non-byline-author.; Delisse B. non-byline-author.; Gibert I. non-byline-author.; Boulay C. non-byline-author.; Verceletto M. non-byline-author.; Durand G. non-byline-author.; Bonneviot G. non-byline-author.; Gil R. non-byline-author.; Hedreville M.A. non-byline-author.; Belair C. non-byline-author.; Poitevin R.J. non-byline-author.; Devoize J.L. non-byline-author.; Wyremblewski P. non-byline-author.; Delestre F. non-byline-author.; Setiey A. non-byline-author.; Comi G. non-byline-author.; Filippi M. non-byline-author.; Ghezzi A. non-byline-author.; Martinelli V. non-byline-author.; Rossi P. non-byline-author.; Zaffaroni M. non-byline-author.; Tola M.R. non-byline-author.; Amato M.P. non-byline-author.; Fioretti C. non-byline-author.; Meucci G. non-byline-author.; Inglese M. non-byline-author.; Mancardi G.L. non-byline-author.; Gambi D. non-byline-author.; Thomas A. non-byline-author.; Cavazzuti M. non-byline-author.; Citterio A. non-byline-author.; Heltberg A. non-byline-author.; Hansen H.J. non-byline-author.; Fernandez O. non-byline-author.; Romero F. non-byline-author.; Arbizu T. non-byline-author.; Hernandez J.J. non-byline-author.; De Andres de Frutos C. non-byline-author.; Geffner Sclarky D. non-byline-author.; Aladro Benito Y. non-byline-author.; Reyes Yanes P. non-byline-author.; Aguilar M non-byline-author.; Burguera J.A. non-byline-author.; Yaya R. non-byline-author.; Bonakim Dib W. non-byline-author.; Arzua-Mouronte D. non-byline-author.; d'Hooghe M.B. non-byline-author.; Sindic C.J.M. non-byline-author.; Carton H. non-byline-author.; Medaer R. non-byline-author.; Roose H. non-byline-author.; Geens K.M.J. non-byline-author.; Guillaume D. non-byline-author.; Van Zandycke M. non-byline-author.; Janssens J. non-byline-author.; Cornette M. non-byline-author.; Mol L. non-byline-author.; Weilbach F. non-byline-author.; Flachenecker P. non-byline-author.; Hartung H.P. non-byline-author.; Haas J. non-byline-author.; Tendolkar I. non-byline-author.; Sindrn E. non-byline-author.; Kölmel H.W. non-byline-author.; Reichel D. non-byline-author.; Rauch M. non-byline-author.; Preuss S. non-byline-author.; Poser S. non-byline-author.; Mauch E. non-byline-author.; Strausser-Fuchs S. non-byline-author.; Kolleger H. non-byline-author.; Hawkins S. non-byline-author.; Howell S.J.L. non-byline-author.; Rees J.E. non-byline-author.; Thompson A. non-byline-author.; Johnson M. non-byline-author.; Boggild M. non-byline-author.; Gregory R.P. non-byline-author.; Bates D. non-byline-author.; Bone I. non-byline-author.; Hutchinson M. non-byline-author.; Polman C. non-byline-author.; Frequin S. non-byline-author.; Jongen P. non-byline-author.; Hommes O. non-byline-author.; Correia de Sa J. non-byline-author.; Rio M.E. non-byline-author.; Huber S. non-byline-author.; Lechner-Scott J. non-byline-author.; Kappos L. non-byline-author.; Ionescu I. non-byline-author.; Cornu C. non-byline-author.; Confavreux C. non-byline-author.; Vukusic S. non-byline-author.; El-Etr M. non-byline-author.; Baulieu E.E. non-byline-author.; El-Etr M. non-byline-author.; Schumacher M non-byline-author.; Ionescu I. non-byline-author.; Confavreux C. non-byline-author.; Cornu C. non-byline-author.; Vukusic S. non-byline-author.; Hartung H.P. non-byline-author.; Miller D.H. non-byline-author.; Hutchinson M. non-byline-author.; Pugeat M. non-byline-author.; d'Archangues C. non-byline-author.; Conard J. non-byline-author.; Ménard J. non-byline-author.; Sitruk-Ware R. non-byline-author.; Pelissier C. non-byline-author.; Dat S. non-byline-author.; Belaïsch-Allard J. non-byline-author.; Athéa N. non-byline-author.; Büschsenschutz D. non-byline-author.; Lyon-Caen O. non-byline-author.; Gonsette R. non-byline-author.; Boissel J.P. non-byline-author.; Ffrench P. non-byline-author.; Durand-Dubief F. non-byline-author.; Cotton F. non-byline-author.; Pachai C. non-byline-author.; Bracoud L. non-byline-author.; Vukusic S. non-byline-author.; Ionescu I. non-byline-author.; Androdias G. non-byline-author.; Marignier R. non-byline-author.; Chauplannaz G. non-byline-author.; Laplaud D.A. non-byline-author.; Wiertlewski S. non-byline-author.; Lanctin-Garcia C. non-byline-author.; Moreau T. non-byline-author.; Couvreur G. non-byline-author.; Madinier G. non-byline-author.; Clavelou P. non-byline-author.; Taithe F. non-byline-author.; Aufauvre D. non-byline-author.; Guy N. non-byline-author.; Ferrier A. non-byline-author.; De Sèze J. non-byline-author.; Collongues N. non-byline-author.; Debouverie M. non-byline-author.; Viala F. non-byline-author.; Brassat D. non-byline-author.; Gerdelat-Mas A. non-byline-author.; Henry P. non-byline-author.; Pelletier J. non-byline-author.; Rico-Lamy A. non-byline-author.; Lebrun-Frenay C. non-byline-author.; Lepage E. non-byline-author.; Deburghraeve V. non-byline-author.; Edan G. non-byline-author.; Castelnovo G. non-byline-author.; Berger E. non-byline-author.; Hautecoeur P. non-byline-author.; Blondiau M. non-byline-author.; Heinzlef O. non-byline-author.; Coustans M. non-byline-author.; Clerc C. non-byline-author.; Rieu L. non-byline-author.; Lauxerois M. non-byline-author.; Hinzelin G. non-byline-author.; Ouallet J.C. non-byline-author.; Minier D. non-byline-author.; Vion P. non-byline-author.; Gromaire-Fayolle N. non-byline-author.; Derache N. non-byline-author.; Thouvenot E. non-byline-author.; Sallansonnet-Froment M. non-byline-author.; Tourniaire P. non-byline-author.; Toureille L. non-byline-author.; Borgel F. non-byline-author.; Stankoff B. non-byline-author.; Grimaud J. non-byline-author.; Moroianu C. non-byline-author.; Guennoc A.M. non-byline-author.; Tournier-Gervason C.L. non-byline-author.; Peysson S. non-byline-author.; Trojano M. non-byline-author.; Patti F. non-byline-author.; D'Amico E. non-byline-author.; Motti L. non-byline-author.; Zaffaroni M. non-byline-author.; Durelli L. non-byline-author.; Tavella A. non-byline-author.;
• Is Part Of: Multiple sclerosis. Volume 25:Number 4(2019)
• Page Start: 591
• Page End: 600
• Publication Date: 2019-04
• Subjects: Multiple sclerosis -- pregnancy -- post-partum -- relapses -- neuraxial analgesia; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458518763080
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Obstetrical analgesia remains a matter of controversy because of the fear of neurotoxicity of local anesthetics on demyelinated fibers or their potential relationship with subsequent relapses. Objective: To assess the impact of neuraxial analgesia on the risk of relapse during the first 3 months post-partum, with a focus on women who experienced relapses during pregnancy. Methods: We analyzed data of women followed-up prospectively during their pregnancies and at least 3 months post-partum, collected in the Pregnancy in Multiple Sclerosis (PRIMS) and Prevention of Post-Partum Relapses with Progestin and Estradiol in Multiple Sclerosis (POPARTMUS) studies between 1992–1995 and 2005–2012, respectively. The association of neuraxial analgesia with the occurrence of a post-partum relapse was estimated by logistic regression analysis. Results: A total of 389 women were included, 215 from PRIMS and 174 from POPARTMUS. In total, 156 women (40%) had neuraxial analgesia. Overall, 24% experienced a relapse during pregnancy and 25% in the 3 months post-partum. Women with a pregnancy relapse were more likely to have a post-partum relapse (odds ratio (OR) = 1.83, p = 0.02), independently of the use of neuraxial analgesia. There was no association between neuraxial analgesia and post-partum relapse (OR = 1.08, p = 0.78). Conclusion: Neuraxial analgesia was not associated with an increased risk of post-partum relapses, whatever multiple sclerosis (MS) activity during pregnancy.