1117: Perinatal outcome of women with documented drug allergy: results from a population-based cohort study

Abstract

Drug allergy is characterized by idiosyncratic and unpredictable immune-mediated reactions to drugs. A successful pregnancy requires maternal immune system adaptation to allow for the growth of an antigenically foreign fetus. Aberrant immune mechanisms have been associated with various gestational complications such as preeclampsia, intrauterine growth restriction (IUGR) and preterm delivery. Due to the association between immune dysfunction and adverse perinatal outcomes, we chose to evaluate the perinatal outcome of women with drug allergy. In a retrospective population-based cohort study, the perinatal outcome was compared between singleton deliveries of women with and without drug allergy. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center. Generalized estimation equation (GEE) models were used to control for confounders. During the study period, 243,682 deliveries met the inclusion criteria, of which 9756 (4.00%) occurred in women with drug allergy. Using GEE models, controlling for maternal age, maternal drug allergy was noted as an independent risk factor for hypertensive disorders, diabetes mellitus, IUGR, and preterm delivery. Pregnancy of women with documented drug allergy is independently associated with adverse perinatal outcomes such as hypertensive disorders, diabetes mellitus IUGR, and preterm delivery. Prenatal exposure to the maternal altered immune system may play a role in pregnancy outcomes of the affected fetuses.