Epub ahead of print: Kim W et al. Influence of pregnancy on neuromyelitis optica spectrum disorder.Neurology 2012 Apr 4.
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. The investigators reviewed medical records and used a structured questionnaire to investigate gravidity (number of pregnancies), parity (number of births), 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.
You already know this story that there is an at-risk period after birth during which time there is an increase in the number of relapses, but this usually is just catching up for the reduced relapse rate during pregnancy. In this study on neomyelitis optica there was no reduction in relapse rate during pregnancy. Check out the blog for previous pregnancy related posts.
16 Sep 2011
21/101 (21%) of births to MS women treated with DMD prior to pregnancy were exposed to a DMD. In all cases, exposure was documented as unintentional and DMD treatment was stopped within 2 months of gestation.
28 Jul 2011
This allowed these investigators to study the association of maternal milk intake, maternal dietary vitamin D intake, and predicted maternal serum vitamin D during pregnancy and their daughters’ risk of developing MS.
31 May 2011
Of the women exposed to natalizumab during pregnancy, 29 women gave birth to 28 healthy children; one child was born with hexadactyly (an extra finger), 5 pregnancies ended in an early miscarriage and one woman …
15 Jul 2011
The average or mean rate of relapse was 0.7 per year in the year before pregnancy, 0.5 during the first trimester, 0.6 during the second trimester and 0.2 during the third. The rate increased to 1.2 during the first three months …
16 Jul 2011
“Because of this study, and the fact that pregnancy itself reduces the attack rate, researcher’s have been trying to find out what it is about pregnancy that is so beneficial for MS’ers.” “We assume that the profound changes that …
20 Dec 2010
Pregnancy and foetal outcomes after interferon-β exposure in multiple sclerosis. A report on 88 pregnancies in Italian woman that were exposed to interferon-beta (average exposure 4 to 5 weeks) has demonstrated that …