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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 4 Iuliana Ionescu 5 Romain Casey 6 Thibault Moreau 7 Patricia Tourniaire 8 Michael Hutchinson 9 Marie Béatrice D’hooghe 10 David-Axel Laplaud 11 Pierre Clavelou 12 Jérôme de Sèze 13 Marc Debouverie 14, 15 David Brassat 16 Jean Pelletier 17 Christine Lebrun-Frenay 18 Emmanuelle Le Page 19, 20 Giovanni Castelnovo 21 Eric Berger 22 Patrick Hautecoeur 23 Olivier Heinzlef 24 Luca Durelli 25 Marinella Clerico 26 Maria Trojano 27 Francesco Patti 28 Pierre Vukusic 29, 30, * A. Alpérovitch 31 H. Carton 32 O. Hommes P. Adeleine 33 A. Biron J. Grimaud M. Hours D. Latombe M. Clanet 34 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 35 M. Verceletto Geoffroy Durand 36 G. Bonneviot R. Gil A. Hedreville C. Belair J. Poitevin J. Devoize P. Wyremblewski F. Delestre A. Setiey G. Comi 17 M. Filippi 17 A. Ghezzi V. Martinelli P. Rossi M. Tola M. Amato C. Fioretti G. Meucci M. Inglese G. Mancardi D. Gambi A. Thomas 37 M. Cavazzuti A. Citterio 38 A. Heltberg H. Hansen O. Fernandez F. Romero T. Arbizu J. Hernández 39 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 40 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 41 S. Poser E. Mauch S. Strausser-Fuchs H. Kolleger S. Hawkins J. Howell J. Rees A. Thompson M. Johnson M. Boggild P. Gregory 42 D. Bates I. Bone C. Polman 17 S. Frequin P. Jongen J. Correia de Sa M. Rio 43 S. Huber J. Lechner-Scott L. Kappos 17 E. Baulieu M. El-Etr 44 M. Schumacher 44 C. Confavreux 45 C. Cornu 46 H. Hartung H. Miller M. Pugeat C. D’archangues J. Conard J. Ménard R. Sitruk-Ware C. Pélissier 47 S. Dat J. Belaïsch-Allard N. Athéa D. Büschsenschutz O. Lyon-Caen R. Gonsette P. Boissel 48 P. Ffrench F. Cotton 3 C. Pachai 45 L. Bracoud S. Vukusic 49, * G. Androdias G. Chauplannaz A. Laplaud S. Wiertlewski 11 C. Lanctin-Garcia G. Couvreur G. Madinier F. Taithe 50 D. Aufauvre N. Guy A. Ferrier 51 N. Collongues 52 F. Viala 53 A. Gerdelat-Mas P. Henry A. Rico-Lamy E. Lepage 17 V. Deburghraeve Gilles Edan 54 M. Blondiau M. Coustans 55 C. Clerc L. Rieu M. Lau G. Hinzelin J. Ouallet D. Minier P. Vion N. Gromaire-Fayolle N. Derache Eric Thouvenot 21 M. Sallansonnet-Froment L. Toureille F. Borgel Bruno Stankoff 56 C. Moroianu A. Guennoc C. Tournier-Gervason S. Peysson E. D’amico L. Motti M. Zaffaroni A. Tavella
* Corresponding author
3 RMN et optique : De la mesure au biomarqueur
CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
33 Biostatistiques santé
Département biostatistiques et modélisation pour la santé et l'environnement [LBBE]
53 LRSI - Laboratoire de Réactivité des Surfaces et des Interfaces
DPC - Département de Physico-Chimie : DEN/DPC
54 Empenn
INSERM - Institut National de la Santé et de la Recherche Médicale, Inria Rennes – Bretagne Atlantique , IRISA-D5 - SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE
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.
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https://hal.univ-lorraine.fr/hal-02158735
Contributor : Agnès Peignier <>
Submitted on : Tuesday, June 18, 2019 - 12:05:27 PM
Last modification on : Saturday, June 19, 2021 - 3:17:36 AM

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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, SAGE Publications, 2019, 25 (4), pp.591-600. ⟨10.1177/1352458518763080⟩. ⟨hal-02158735⟩

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