Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy

Background Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002–2022 period and compa...

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Published in:	Journal of neurology Vol. 270; no. 9; pp. 4498 - 4506
Main Authors:	Krief, Nolwenn, Gabriel, René, Cauquil, Cécile, Adams, David, Fargeot, Guillaume, Maisonobe, Thierry, Osman, David, Schmidt, Matthieu, Chanson, Jean-Baptiste, Bigaut, Kevin, Sole, Guilhem, Tard, Céline, Nicolas, Guillaume, Pereon, Yann, Aure, Karine, Lagrange, Emmeline, Lefilliatre, Mathilde, Labeyrie, Marc-Antoine, Echaniz-Laguna, Andoni
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2023 Springer Nature B.V Springer Verlag
Subjects:	Adult Age Cesarean Section Cytomegalovirus Cytomegalovirus Infections Demyelination Female Fetus Fetuses Guillain-Barre syndrome Guillain-Barre Syndrome - complications Guillain-Barre Syndrome - diagnosis Guillain-Barre Syndrome - therapy Humans Immunoglobulins Infections Inflammation Life Sciences Medicine Medicine & Public Health Neurology Neurons and Cognition Neuroradiology Neurosciences Original Communication Patients Pregnancy Retrospective Studies Pregnancy Cytomegalovirus Guillain-Barré syndrome Cytomegalovirus; Guillain-Barré syndrome; Pregnancy
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Abstract	Background Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002–2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe. Results We identified 16 pGBS cases. Median age was 31 years (28–36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27–33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%). Conclusions This study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality.
AbstractList	BackgroundGuillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy.MethodsIn this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002–2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe.ResultsWe identified 16 pGBS cases. Median age was 31 years (28–36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27–33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%).ConclusionsThis study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality. Guillain-Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002-2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe. We identified 16 pGBS cases. Median age was 31 years (28-36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27-33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%). This study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality. Background: Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods: In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002–2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe. Results: We identified 16 pGBS cases. Median age was 31 years (28–36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27–33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%). Conclusions: This study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality. Background Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002–2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe. Results We identified 16 pGBS cases. Median age was 31 years (28–36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27–33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%). Conclusions This study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality.
Author	Cauquil, Cécile Bigaut, Kevin Chanson, Jean-Baptiste Gabriel, René Schmidt, Matthieu Pereon, Yann Aure, Karine Maisonobe, Thierry Krief, Nolwenn Sole, Guilhem Echaniz-Laguna, Andoni Lagrange, Emmeline Adams, David Nicolas, Guillaume Osman, David Labeyrie, Marc-Antoine Tard, Céline Fargeot, Guillaume Lefilliatre, Mathilde
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Keywords	Pregnancy Cytomegalovirus Guillain-Barré syndrome Cytomegalovirus; Guillain-Barré syndrome; Pregnancy
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Snippet	Background Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods In this retrospective study,... Guillain-Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. In this retrospective study, we analyzed the... BackgroundGuillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy.MethodsIn this retrospective study, we... BACKGROUNDGuillain-Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy.METHODSIn this retrospective study, we... Background: Guillain–Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. Methods: In this retrospective...
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SubjectTerms	Adult Age Cesarean Section Cytomegalovirus Cytomegalovirus Infections Demyelination Female Fetus Fetuses Guillain-Barre syndrome Guillain-Barre Syndrome - complications Guillain-Barre Syndrome - diagnosis Guillain-Barre Syndrome - therapy Humans Immunoglobulins Infections Inflammation Life Sciences Medicine Medicine & Public Health Neurology Neurons and Cognition Neuroradiology Neurosciences Original Communication Patients Pregnancy Retrospective Studies
Title	Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy
URI	https://link.springer.com/article/10.1007/s00415-023-11808-w https://www.ncbi.nlm.nih.gov/pubmed/37294323 https://www.proquest.com/docview/2849175458 https://search.proquest.com/docview/2824685573 https://hal.science/hal-04190831 https://pubmed.ncbi.nlm.nih.gov/PMC10252168
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