title: Possible effects of anaesthetic management on the 1 yr followed-up risk of herpes zoster after Caesarean deliveries.
abstract: BACKGROUND
  As general anaesthesia may compromise the immune system, it has been hypothesized that latent varicella-zoster virus is more likely to be reactivated and cause herpes zoster in mothers after Caesarean deliveries under general anaesthesia. Our study was thus aimed at investigating the risk of herpes zoster among women during the first year after Caesarean deliveries under either general or regional anaesthesia.
  
  
  METHODS
  Two nationwide population-based data sets were utilized, including the Taiwan birth certificate registry and the Taiwan National Health Insurance Research Dataset. From 2001 to 2003, a total of 162 495 women underwent Caesarean delivery. Among them, 21 454 women received general anaesthesia, whereas 141 041 patients received regional anaesthesia. Each individual was followed for 1 yr to identify the subsequent occurrence of herpes zoster. Cox's proportional hazards regressions were performed for analysis.
  
  
  RESULTS
  During the 1 yr follow-up period, 0.46% of the women receiving general anaesthesia experienced an episode of herpes zoster, compared with 0.34% of women receiving regional anaesthesia. In Caesarean deliveries, the use of general anaesthesia compared with regional anaesthesia was independently associated with a 1.29-fold (95% confidence interval=1.04-1.61) increase in the 1 yr risk of herpes zoster, after adjusting for maternal and infant characteristics.
  
  
  CONCLUSIONS
  In this series, there was a small increased risk of herpes zoster in the year after Caesarean delivery with general anaesthesia. Future studies are needed to further investigate these findings.
authors.affiliation: College of Public Health and Nutrition, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Chen
authors.forename: R-H
authors.initials: RH
authors.lastname: Rau
authors.forename: J J
authors.initials: JJ
authors.lastname: Keller
authors.forename: H-C
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000009:adverse effects / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology / Q000209:etiology*; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D011247:Pregnancy; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D014775:Virus Activation; D055815:Young Adult