Yanlu Huang1, Yuge Wang1, Yifan Zhou1, Qiao Huang2, Xiaobo Sun1, Chen Chen1, Ling Fang1, Youming Long3, Hui Yang4, Honghao Wang5, Caixia Li6, Zhengqi Lu1, Xueqiang Hu1, Allan G Kermode7, Wei Qiu8. 1. Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 2. Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Neurology, Zhaoqing No. 2 People's Hospital, Guangzhou, China. 3. Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 4. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. 5. Department of Neurology, Nanfang Hospital of Nanfang Medical University, Guangzhou, China. 6. School of Mathematics and Computational Science, Sun Yat-sen University, Guangzhou, China. 7. Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, Perth, Australia. 8. Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: qw9406@gmail.com.
Abstract
OBJECTIVE: This study aimed to assess the effect of pregnancy on the course of neuromyelitis optica spectrum disorder (NMOSD), and the effect of this disease on pregnancy outcomes. METHODS: Consecutive patients with NMOSD were recruited between September 2015 and April 2016 at an outpatient clinic from four referral institutes in South China. Demographic, clinical, and pregnancy data were retrieved by questionnaires to analyze the association between NMOSD and pregnancy, as well as the potential risk factors for relapse. RESULTS: Among 249 patients with NMOSD, 55 had pregnancy-related attacks. The annual relapse rate in the first (3.20±6.82) and second (3.25±3.32) 3-month postpartum periods was marginally higher than that before pregnancy (1.44±0.92, p=0.682) and during pregnancy (1.23±1.32, p=0.758). The Kurtzke Expanded Disability Status Scale score increased from 1.55±0.38 before pregnancy to 2.88±2.14 at postpartum (p<0.001). NMOSD significantly increased the premature birth rate in patients after disease onset (8.33%) compared with before disease onset (1.95%, p=0.025). Multivariate analysis showed that negative anti-aquaporin-4 IgG, concomitance with autoimmune diseases/antibodies, and no treatment in remission were risk factors of recurrence. CONCLUSION: Our study shows a significant association between pregnancy and NMOSD in the Chinese population. Larger scale prospective studies are warranted in the future.
OBJECTIVE: This study aimed to assess the effect of pregnancy on the course of neuromyelitis optica spectrum disorder (NMOSD), and the effect of this disease on pregnancy outcomes. METHODS: Consecutive patients with NMOSD were recruited between September 2015 and April 2016 at an outpatient clinic from four referral institutes in South China. Demographic, clinical, and pregnancy data were retrieved by questionnaires to analyze the association between NMOSD and pregnancy, as well as the potential risk factors for relapse. RESULTS: Among 249 patients with NMOSD, 55 had pregnancy-related attacks. The annual relapse rate in the first (3.20±6.82) and second (3.25±3.32) 3-month postpartum periods was marginally higher than that before pregnancy (1.44±0.92, p=0.682) and during pregnancy (1.23±1.32, p=0.758). The Kurtzke Expanded Disability Status Scale score increased from 1.55±0.38 before pregnancy to 2.88±2.14 at postpartum (p<0.001). NMOSD significantly increased the premature birth rate in patients after disease onset (8.33%) compared with before disease onset (1.95%, p=0.025). Multivariate analysis showed that negative anti-aquaporin-4 IgG, concomitance with autoimmune diseases/antibodies, and no treatment in remission were risk factors of recurrence. CONCLUSION: Our study shows a significant association between pregnancy and NMOSD in the Chinese population. Larger scale prospective studies are warranted in the future.
Authors: Madina Tugizova; Luka Vlahovic; Anna Tomczak; Nora Sandrine Wetzel; May Htwe Han Journal: Curr Treat Options Neurol Date: 2021-03-30 Impact factor: 3.972