TY - JOUR
T1 - Influence of pregnancy on neuromyelitis optica spectrum disorder
AU - Kim, W.
AU - Kim, S. H.
AU - Nakashima, I.
AU - Takai, Y.
AU - Fujihara, K.
AU - Leite, M. I.
AU - Kitley, J.
AU - Palace, J.
AU - Santos, E.
AU - Coutinho, E.
AU - Silva, A. M.
AU - Kim, Byoung Joon
AU - Kim, Byung Jo
AU - Ahn, S. W.
AU - Kim, H. J.
N1 - Funding Information:
Dr. W. Kim and Dr. S.-H. Kim report no disclosures. Dr. Nakashima has received funding for travel and received speaker honoraria from Bayer Schering Pharma and Biogen Idec and has received research funding from Mitsubishi Chemical Medience Corporation and Grants-in-Aid for Scientific Research from the Ministry of Education, Science and Technology of Japan. Dr. Takai reports no disclosures. Dr. Fujihara serves on scientific advisory boards for Bayer Schering Pharma, Biogen Idec, and Merck Serono; has received funding for travel and speaker honoraria from Bayer Schering Pharma, Biogen Idec, Eisai Inc., Mitsubishi Tanabe Pharma Corporation, Astellas Pharma Inc., Takeda Pharmaceutical Company Limited, and Asahi Kasei Kuraray Medical Co., Ltd.; serves on the editorial board of Clinical and Experimental Neuroimmunology ; receives royalties from the publication of Clinical Practice Guide of Orthopedic Surgery (Bunkodo, 2007); and has received research support from Bayer Schering Pharma, Biogen Idec Japan, Asahi Kasei Kuraray Medical Co., The Chemo-Sero-Therapeutic Research Institute, Teva Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation, Teijin Pharma, Eisai Inc., and Kowa Pharmaceuticals America, Inc. and Grants-in-Aid for Scientific Research from the Ministry of Education, Science and Technology and the Ministry of Health, Labor and Welfare of Japan. Dr. Leite and Dr. Kitley report no disclosures. Dr. Palace has received support for MS-related scientific meetings and honorariums for advisory committees from Merck Serono, Biogen Idec, Novartis, Teva, and Bayer Schering and support for investigator-led research from Merck Serona and Bayer Schering. Dr. Santos and Dr. Coutinho report no disclosures. Dr. Silva has received support for MS-related scientific meetings and honoraria for advisory committees from Merck Serono, Biogen Idec, Novartis, Teva, and Bayer Schering. Dr. Byoung-Joon Kim, Dr. Byung-Jo Kim, and Dr. Ahn report no disclosures. Dr. H.J. Kim has received research grant from the Ministry for Health, Welfare and Family Affairs and honoraria for speaking or consulting from Bayer Schering Pharma, Merck Serono, and Novartis.
PY - 2012/4/17
Y1 - 2012/4/17
N2 - 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.
AB - 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.
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U2 - 10.1212/WNL.0b013e318250d812
DO - 10.1212/WNL.0b013e318250d812
M3 - Review article
C2 - 22491862
AN - SCOPUS:84860708188
VL - 78
SP - 1264
EP - 1267
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 16
ER -