Influence of pregnancy on neuromyelitis optica spectrum disorder

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

Research output: Contribution to journalReview article

55 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1264-1267
Number of pages4
JournalNeurology
Volume78
Issue number16
DOIs
Publication statusPublished - 2012 Apr 17

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Neuromyelitis Optica
Pregnancy
Recurrence
Second Pregnancy Trimester
First Pregnancy Trimester
Aquaporin 4
Gravidity
Stillbirth
Spontaneous Abortion
Pregnancy Rate
Parity
Postpartum Period
Medical Records
Referral and Consultation
Prospective Studies
Antibodies

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Kim, W., Kim, S. H., Nakashima, I., Takai, Y., Fujihara, K., Leite, M. I., ... Kim, H. J. (2012). Influence of pregnancy on neuromyelitis optica spectrum disorder. Neurology, 78(16), 1264-1267. https://doi.org/10.1212/WNL.0b013e318250d812

Influence of pregnancy on neuromyelitis optica spectrum disorder. / Kim, W.; Kim, S. H.; Nakashima, I.; Takai, Y.; Fujihara, K.; Leite, M. I.; Kitley, J.; Palace, J.; Santos, E.; Coutinho, E.; Silva, A. M.; Kim, Byoung Joon; Kim, Byung Jo; Ahn, S. W.; Kim, H. J.

In: Neurology, Vol. 78, No. 16, 17.04.2012, p. 1264-1267.

Research output: Contribution to journalReview article

Kim, W, Kim, SH, Nakashima, I, Takai, Y, Fujihara, K, Leite, MI, Kitley, J, Palace, J, Santos, E, Coutinho, E, Silva, AM, Kim, BJ, Kim, BJ, Ahn, SW & Kim, HJ 2012, 'Influence of pregnancy on neuromyelitis optica spectrum disorder', Neurology, vol. 78, no. 16, pp. 1264-1267. https://doi.org/10.1212/WNL.0b013e318250d812
Kim W, Kim SH, Nakashima I, Takai Y, Fujihara K, Leite MI et al. Influence of pregnancy on neuromyelitis optica spectrum disorder. Neurology. 2012 Apr 17;78(16):1264-1267. https://doi.org/10.1212/WNL.0b013e318250d812
Kim, W. ; Kim, S. H. ; Nakashima, I. ; Takai, Y. ; Fujihara, K. ; Leite, M. I. ; Kitley, J. ; Palace, J. ; Santos, E. ; Coutinho, E. ; Silva, A. M. ; Kim, Byoung Joon ; Kim, Byung Jo ; Ahn, S. W. ; Kim, H. J. / Influence of pregnancy on neuromyelitis optica spectrum disorder. In: Neurology. 2012 ; Vol. 78, No. 16. pp. 1264-1267.
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AU - Santos, E.

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AU - Silva, A. M.

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