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Influence of pregnancy on neuromyelitis optica spectrum disorder.
MedLine Citation:
PMID:  22491862     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:To investigate the influence of pregnancy on patients with neuromyelitis optica spectrum disorder (NMOSD). METHODS:A total of 190 women with NMOSD were enrolled from 7 referral hospitals in 4 countries. We reviewed medical records and used a structured questionnaire to investigate gravidity, parity, and the number of relapses during the 2 years before pregnancy, during each trimester of pregnancy, during the first and second trimesters after delivery, and for 6 months thereafter. The annualized relapse rate (ARR) was calculated for each period. RESULTS:Of the 190 women with NMOSD, 40 patients experienced 54 informative pregnancies, and all of them were seropositive for aquaporin-4 antibody. Fourteen patients developed the first symptoms of NMOSD either during the pregnancy (3 patients) or within a year after delivery or abortion (8 and 3 patients, respectively). Twenty-six patients experienced 40 pregnancies after the onset of NMOSD (26 deliveries and 14 abortions [1 spontaneous and 13 elective]). There was one preterm delivery with birth defects and no stillbirths. The ARR during pregnancy did not differ from that before pregnancy, but it increased significantly during the first and second trimesters after delivery (5.3 and 3.7 times, respectively). Moreover, 77% of the deliveries were associated with postpartum relapses. CONCLUSION:The significantly increased relapse rate and numerous cases of NMOSD onset after pregnancy suggest that delivery adversely affects the course of NMOSD. Prospective studies are needed to confirm our findings.
Authors:
W Kim; S-H Kim; I Nakashima; Y Takai; K Fujihara; M I Leite; J Kitley; J Palace; E Santos; E Coutinho; A M Silva; Byoung-Joon Kim; Byung-Jo Kim; S-W Ahn; H J Kim
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-4
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Neurology (W.K., S.-H.K., H.J.K.), Research Institute and Hospital of National Cancer Center, Goyang, Korea; Department of Neurology (I.N., Y.T.), Tohoku University School of Medicine, Sendai; Department of Multiple Sclerosis Therapeutics (K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Nuffield Department of Clinical Neurosciences (M.I.L., J.K., J.P.), John Radcliffe Hospital, University of Oxford, UK; Department of Neurology (E.S., E.C., A.M.S.), Centro Hospitalar Porto, University of Porto, Portugal; Department of Neurology (Byoung-Joon K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Department of Neurology (Byung-Jo K.), College of Medicine, Korea University, Seoul; and Department of Neurology (S.-W.A.), Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
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