Maternal and newborn outcomes in pregnancies complicated by Guillain-Barré syndrome

Abstract

Abstract Objectives Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that affects the peripheral nervous system. The purpose of our study was to evaluate maternal and fetal/neonatal outcomes among pregnancies complicated by GBS. Methods We performed a retrospective cohort study using the Healthcare Cost and Utilization Project – National Inpatient Sample from the United States. ICD-9 codes were used to identify all pregnant women who delivered between 1999 and 2015 and had a diagnosis of GBS. The remaining women without GBS who delivered during that time period constituted the comparison group. The associations between maternal GBS and obstetrical and fetal/neonatal outcomes were evaluated using multivariate logistic regression, while adjusting for the confounding effects of maternal characteristics. Results Of 13,792,544 births included in our study, 291 were to women with GBS, for an overall incidence of 2.1/100,000 births. A steady increase in maternal GBS was observed over the study period (from 1.26 to 3.8/100,000 births, p=0.02). Further, women with GBS were more likely to have pregnancies complicated by preeclampsia, OR 1.69 (95 % CI 1.06–2.69), sepsis, 9.30 (2.33–37.17), postpartum hemorrhage, 1.83 (1.07–3.14), and to require a transfusion, 4.39 (2.39–8.05). They were also at greater risk of caesarean delivery, 2.07 (1.58–2.72) and increased length of hospital stay, 4.48 (3.00–6.69). Newborns of women with GBS were more likely to be growth restricted, 2.50 (1.48–4.23). Conclusions GBS in pregnancy is associated with maternal and newborn adverse outcomes. These patients would benefit from close follow-up throughout their pregnancy and in the postpartum period.