{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:26:30Z","timestamp":1790256390567,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,1,3]],"date-time":"2018-01-03T00:00:00Z","timestamp":1514937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000276","name":"Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006662","name":"National Institute on Handicapped Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/K501256\/1"],"award-info":[{"award-number":["MR\/K501256\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to estimate the incidence of anaphylaxis in pregnancy and describe the management and outcomes in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A population\u2010based descriptive study using the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> Obstetric Surveillance System (<jats:styled-content style=\"fixed-case\">UKOSS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All consultant\u2010led maternity units in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All pregnant women who had anaphylaxis between 1 October 2012 and 30 September 2015. Anaphylaxis was defined as a severe, life\u2010threatening generalised or systemic hypersensitivity reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective case notification using <jats:styled-content style=\"fixed-case\">UKOSS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal mortality, severe maternal morbidity, neonatal mortality and severe neonatal morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 37 confirmed cases of anaphylaxis in pregnancy, giving an estimated incidence of 1.6 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.1\u20132.2) per 100\u00a0000 maternities. Four cases of anaphylaxis were in women with known penicillin allergies: two received co\u2010amoxiclav and two cephalosporins. Twelve women had anaphylaxis following prophylactic use of antibiotics at the time of a caesarean delivery. Prophylactic use of antibiotics for Group B streptococcal infection accounted for anaphylaxis in one woman. Two women died (5%), 14 (38%) women were admitted to intensive care and seven women (19%) had one or more additional severe maternal morbidities, which included three haemorrhagic events, two cardiac arrests, one thrombotic event and one pneumonia. No infants died; however, in those infants whose mother had anaphylaxis before delivery (<jats:italic>n<\/jats:italic>\u00a0=\u00a018) there were seven (41%) neonatal intensive care unit admissions, three preterm births and one baby was cooled for neonatal encephalopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Anaphylaxis is a rare severe complication of pregnancy and frequently the result of a reaction to antibiotic administration. This study highlights the seriousness of the outcomes of this condition for the mother. The low incidence is reassuring given the large proportion of the pregnant population that receive prophylactic antibiotics during delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Anaphylaxis is a rare severe complication of pregnancy and frequently the result of a reaction to antibiotic administration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15041","type":"journal-article","created":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T17:33:59Z","timestamp":1511976839000},"page":"965-971","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["The incidence, characteristics, management and outcomes of anaphylaxis in pregnancy: a population\u2010based descriptive study"],"prefix":"10.1111","volume":"125","author":[{"given":"SJ","family":"McCall","sequence":"first","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit (NPEU) Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KJ","family":"Bunch","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit (NPEU) Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Brocklehurst","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit (NPEU) Nuffield Department of Population Health University of Oxford Oxford UK"},{"name":"Birmingham Clinical Trials Unit University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"D'Arcy","sequence":"additional","affiliation":[{"name":"Nuffield Department of Obstetrics and Gynaecology John Radcliffe Hospital University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Hinshaw","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sunderland Royal Hospital Sunderland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJ","family":"Kurinczuk","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit (NPEU) Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DN","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics Northwick Park Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Stenson","sequence":"additional","affiliation":[{"name":"Neonatal Unit Royal Infirmary of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DJ","family":"Tuffnell","sequence":"additional","affiliation":[{"name":"Teaching Hospitals Foundation NHS Trust Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Knight","sequence":"additional","affiliation":[{"name":"Policy Research Unit in Maternal Health and Care National Perinatal Epidemiology Unit (NPEU) Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2008.00775.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443610802260595"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000067888"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60667-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2005.05.001"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e328355b7e4"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2009.11.005"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.06.035"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","unstructured":"SheikhA AlvesB.Hospital admissions for acute anaphylaxis: time trend study.BMJ2000;320:1441.","DOI":"10.1136\/bmj.320.7247.1441"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei066"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-007055"},{"key":"e_1_2_7_13_1","unstructured":"Royal College of Obstetrics and Gynaecology (RCOG).The prevention of early\u2010onset neonatal group B streptococcal disease. Green\u2013top guideline no. 36 2012."},{"key":"e_1_2_7_14_1","volume-title":"Universal Antenatal Culture\u2010Based Screening for Maternal Group B Streptococcus (gbs) Carriage to Prevent Early\u2010Onset gbs Disease","author":"Seedat F","year":"2016"},{"key":"e_1_2_7_15_1","volume-title":"Emergency Treatment of Anaphylactic Reactions; Guidelines for Healthcare Professionals","author":"Resuscitation Council (UK)","year":"2008"},{"key":"e_1_2_7_16_1","volume-title":"Management of a Patient with Suspected Anaphylaxis During Anaesthesia","author":"The Association of Anaesthetists of Great Britain & Ireland","year":"2009"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2008.02.001"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00609.x"},{"key":"e_1_2_7_19_1","volume-title":"Caesarean Section (Clinical Guideline CG132)","author":"National Institute for Health and Care Excellence","year":"2011"},{"key":"e_1_2_7_20_1","unstructured":"2007 CEMACH London G Penney D Kernaghan V Brace Severe maternal morbidity \u2013 the Scottish experience 2003 to 2005 248 53"},{"key":"e_1_2_7_21_1","volume-title":"Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines from CDC, 2010","author":"Verani JR","year":"2010"},{"key":"e_1_2_7_22_1","volume-title":"Saving Lives, Improving Mothers' Care \u2013 Surveillance of Maternal Deaths in the UK 2012\u201314 and Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009\u201314","author":"Knight M","year":"2016"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3182a706c7"},{"key":"e_1_2_7_24_1","first-page":"655","article-title":"Anaphylaxis to cefazolin during labor secondary to prophylaxis for group B streptococcus: a case report","volume":"51","author":"Jao MS","year":"2006","journal-title":"J Reprod Med"},{"key":"e_1_2_7_25_1","first-page":"381","article-title":"Anaphylaxis in labor secondary to prophylaxis against group B Streptococcus. A case report","volume":"44","author":"Dunn AB","year":"1999","journal-title":"J Reprod Med"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00062.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02729.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer131"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2008.05.002"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.971069"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer192"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.15041","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15041","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:52:17Z","timestamp":1694998337000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.15041"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,3]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1111\/1471-0528.15041"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.15041","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,3]]},"assertion":[{"value":"2017-11-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}