Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS - Université de Lorraine Access content directly
Journal Articles Multiple Sclerosis Journal Year : 2019

Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS

Caroline Lavie (1) , Fabien Rollot (2) , Françoise Durand-Dubief (3) , Romain Marignier (3, 4) , Iuliana Ionescu (3) , Romain Casey (2) , Thibault Moreau (5) , Patricia Tourniaire (6) , Michael Hutchinson (7, 8) , Marie Béatrice D’hooghe (9, 7) , David-Axel Laplaud (10) , Pierre Clavelou (11, 12) , Jérôme de Sèze (13, 14) , Marc Debouverie (15, 16) , David Brassat (17, 18) , Jean Pelletier (19, 20) , Christine Lebrun-Frenay (21, 22) , Emmanuelle Le Page (23) , Giovanni Castelnovo (24) , Eric Berger (25) , Patrick Hautecoeur (26) , Olivier Heinzlef (27) , Luca Durelli (28) , Marinella Clerico (28) , Maria Trojano (28) , Francesco Patti (29) , Sandra Vukusic (30, 2, 4) , A. Alpérovitch , H. Carton , O. Hommes , P. Adeleine (31) , A. Biron , J. Grimaud , M. Hours , D. Latombe , M. Clanet (32) , G. Lau , L. Rumbach , J. Goas , F. Rouhart , A. Mazingue , E. Roullet , M. Madigand , P. Brunet , C. Allaire , G. Riffault , J. Leche , T. Benoit , C. Simonin , F. Ziegler , J. Baron , Y. Rivrain , R. Dumas , D. Loche , J. Bourrin , B. Huttin , B. Delisse , I. Gibert , C. Boulay (33) , M. Verceletto , Geoffroy Durand , G. Bonneviot , R. Gil , A. Hedreville , C. Belair , J. Poitevin , J. Devoize , P. Wyremblewski , F. Delestre , A. Setiey , G. Comi (19) , M. Filippi (19) , A. Ghezzi , V. Martinelli , P. Rossi , M. Tola , M. Amato , C. Fioretti , G. Meucci , M. Inglese , G. Mancardi , D. Gambi , A. Thomas (34) , M. Cavazzuti , A. Citterio (35) , A. Heltberg , H. Hansen , O. Fernandez , F. Romero , T. Arbizu , J. Hernández (36) , C. de Andres de Frutos , D. Geffner Sclarky , Y. Aladro Benito , P. Reyes Yanes , M Aguilar , A. Burguera , R. Yaya , W. Bonakim Dib , D. Arzua-Mouronte , M.B. D’hooghe , M. Sindic , R. Medaer , H. Roose , M. Geens , D. Guillaume , M. van Zandycke , J. Janssens , M. Cornette , L. Mol , F. Weilbach , P. Flachenecker , J. Haas , I. Tendolkar , E. Sindrn , H. Kölmel , D. Reichel , M. Rauch , S. Preuss (37) , S. Poser , E. Mauch , S. Strausser-Fuchs , H. Kolleger , S. Hawkins , J. Howell , J. Rees , A. Thompson , M. Johnson , M. Boggild , P. Gregory (38) , D. Bates , I. Bone , C. Polman (19) , S. Frequin , P. Jongen , J. Correia de Sa , M. Rio (39) , S. Huber , J. Lechner-Scott , Ludwig Kappos (19) , E. Baulieu , M. El-Etr (40) , M. Schumacher (40) , C. Confavreux (41) , C. Cornu (42) , H. Hartung , H. Miller , M. Pugeat , C. D’archangues , J. Conard , J. Ménard , R. Sitruk-Ware , C. Pélissier , S. Dat , J. Belaïsch-Allard , N. Athéa , D. Büschsenschutz , O. Lyon-Caen , R. Gonsette , P. Boissel (43) , P. Ffrench , F. Cotton (44) , C. Pachai (41) , L. Bracoud , S. Vukusic (45) , G. Androdias , G. Chauplannaz , A. Laplaud , S. Wiertlewski (10) , C. Lanctin-Garcia , G. Couvreur , G. Madinier , F. Taithe (46) , D. Aufauvre , N. Guy , A. Ferrier (47) , N. Collongues (48) , F. Viala (49) , A. Gerdelat-Mas , P. Henry , A. Rico-Lamy , E. Lepage (19) , V. Deburghraeve , Gilles Edan (50) , M. Blondiau , M. Coustans (51) , C. Clerc , L. Rieu , M. Lau , G. Hinzelin , J. Ouallet , D. Minier , P. Vion , N. Gromaire-Fayolle , N. Derache , Eric Thouvenot (24) , M. Sallansonnet-Froment , L. Toureille , F. Borgel , Bruno Stankoff (52) , C. Moroianu , A. Guennoc , C. Tournier-Gervason , S. Peysson , E. D’amico , L. Motti , M. Zaffaroni , A. Tavella
1 Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
2 OFSEP - Observatoire Français de la Sclérose En Plaques [Lyon]
3 Service de neurologie fonctionnelle et d'épileptologie [Hôpital Pierre Wertheimer-HCL]
4 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
5 Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon)
6 Centre Hospitalier Henri Duffaut (Avignon)
7 National MS Center Melsbroek
8 VUB - Vrije Universiteit Brussel [Bruxelles]
9 VUB - Vrije Universiteit Brussel
10 U1064 Inserm - CRTI - Centre de Recherche en Transplantation et Immunologie
11 Service de Neurologie [CHU Clermont-Ferrand]
12 Neuro-Dol - Neuro-Dol
13 LNV - Laboratoire de Neuroimagerie in Vivo
14 HUS - Les Hôpitaux Universitaires de Strasbourg
15 Service de neurologie [CHRU Nancy]
16 APEMAC - Maladies chroniques, santé perçue, et processus d'adaptation
17 Neurologie vasculaire, pathologie neuro-dégénérative et explorations fonctionnelles du système nerveux [Toulouse]
18 CPTP - Centre de Physiopathologie Toulouse Purpan
19 CRMBM - Centre de résonance magnétique biologique et médicale
20 TIMONE - Hôpital de la Timone [CHU - APHM]
21 CHU Nice - Centre Hospitalier Universitaire de Nice
22 UniCA - Université Côte d'Azur
23 CIC - Centre d'Investigation Clinique [Rennes]
24 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
25 Service de Neurologie [CHRU Besançon]
26 GHICL - Groupe Hospitalier de l'Institut Catholique de Lille
27 Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy]
28 UNITO - Università degli studi di Torino = University of Turin
29 Unict - Università degli studi di Catania = University of Catania
30 HCL - Hospices Civils de Lyon, Departement de Neurologie
31 Biostatistiques santé
32 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
33 PMTE - Protéines membranaires transductrices d'énergie
34 CERMAV - Centre de Recherches sur les Macromolécules Végétales
35 EVS - Environnement, Ville, Société
36 Solvay (France)
37 Institute of Evolutionary Biology
38 Université de Lille, Sciences et Technologies
39 Service de Génétique Médicale [CHU Necker]
40 Différenciation, interaction, activation et migration des sous-populations lymphocitaires humaines
41 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
42 MIP - Motricité, interactions, performance EA 4334 / Movement - Interactions - Performance
43 LCPO - Laboratoire de Chimie Physique D'Orsay
44 RMN et optique : De la mesure au biomarqueur
45 Department of Neurology
46 CHU Clermont-Ferrand
47 IRCP - Institut de Recherche de Chimie Paris
48 Hôpital de Hautepierre [Strasbourg]
49 LRSI - Laboratoire de Réactivité des Surfaces et des Interfaces
50 Empenn - Neuroimagerie: méthodes et applications
51 Service de Neurologie [Rennes] = Neurology [Rennes]
52 Biologie des Interactions Neurones / Glie
A. Alpérovitch
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H. Carton
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O. Hommes
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A. Biron
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J. Grimaud
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M. Hours
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D. Latombe
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G. Lau
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L. Rumbach
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J. Goas
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F. Rouhart
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A. Mazingue
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E. Roullet
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M. Madigand
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P. Brunet
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C. Allaire
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G. Riffault
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J. Leche
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T. Benoit
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C. Simonin
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F. Ziegler
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J. Baron
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Y. Rivrain
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R. Dumas
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D. Loche
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J. Bourrin
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B. Huttin
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B. Delisse
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I. Gibert
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M. Verceletto
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Geoffroy Durand
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G. Bonneviot
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R. Gil
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A. Hedreville
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C. Belair
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J. Poitevin
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J. Devoize
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P. Wyremblewski
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F. Delestre
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A. Setiey
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A. Ghezzi
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V. Martinelli
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P. Rossi
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M. Tola
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M. Amato
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C. Fioretti
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G. Meucci
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M. Inglese
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G. Mancardi
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D. Gambi
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A. Thomas
M. Cavazzuti
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A. Heltberg
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H. Hansen
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O. Fernandez
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F. Romero
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T. Arbizu
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J. Hernández
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C. de Andres de Frutos
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D. Geffner Sclarky
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Y. Aladro Benito
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P. Reyes Yanes
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M Aguilar
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A. Burguera
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R. Yaya
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W. Bonakim Dib
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D. Arzua-Mouronte
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M.B. D’hooghe
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M. Sindic
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R. Medaer
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H. Roose
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M. Geens
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D. Guillaume
M. van Zandycke
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J. Janssens
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M. Cornette
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L. Mol
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F. Weilbach
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P. Flachenecker
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J. Haas
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I. Tendolkar
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E. Sindrn
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H. Kölmel
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D. Reichel
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M. Rauch
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S. Poser
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E. Mauch
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S. Strausser-Fuchs
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H. Kolleger
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S. Hawkins
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J. Howell
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J. Rees
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A. Thompson
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M. Johnson
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M. Boggild
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D. Bates
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I. Bone
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S. Frequin
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P. Jongen
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J. Correia de Sa
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S. Huber
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J. Lechner-Scott
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E. Baulieu
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H. Hartung
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H. Miller
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M. Pugeat
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C. D’archangues
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J. Conard
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J. Ménard
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R. Sitruk-Ware
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C. Pélissier
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S. Dat
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J. Belaïsch-Allard
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N. Athéa
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D. Büschsenschutz
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O. Lyon-Caen
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R. Gonsette
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P. Ffrench
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F. Cotton
L. Bracoud
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S. Vukusic
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G. Androdias
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G. Chauplannaz
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A. Laplaud
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C. Lanctin-Garcia
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G. Couvreur
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G. Madinier
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F. Taithe
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D. Aufauvre
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N. Guy
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A. Ferrier
N. Collongues
A. Gerdelat-Mas
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P. Henry
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A. Rico-Lamy
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V. Deburghraeve
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Gilles Edan
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M. Blondiau
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C. Clerc
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L. Rieu
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M. Lau
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G. Hinzelin
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J. Ouallet
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D. Minier
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P. Vion
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N. Gromaire-Fayolle
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N. Derache
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Eric Thouvenot
M. Sallansonnet-Froment
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L. Toureille
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F. Borgel
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Bruno Stankoff
C. Moroianu
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A. Guennoc
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C. Tournier-Gervason
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S. Peysson
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E. D’amico
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L. Motti
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M. Zaffaroni
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A. Tavella
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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.

Dates and versions

hal-02158735 , version 1 (18-06-2019)

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Caroline Lavie, Fabien Rollot, Françoise Durand-Dubief, Romain Marignier, Iuliana Ionescu, et al.. Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS. Multiple Sclerosis Journal, 2019, 25 (4), pp.591-600. ⟨10.1177/1352458518763080⟩. ⟨hal-02158735⟩
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