Analysis of Pregnancy-Related Attacks in Neuromyelitis Optica Spectrum Disorder. A Systematic Review and Meta-Analysis
Journal: JAMA Network Open; August 4, 2022
Author(s): Liang Wang, Manqiqige Su, Zhirui Zhou, Lei Zhou, Jingzi ZhangBao, Hongmei Tan, Wenjuan Huang, Xuechun Chang, Chuanzhen Lu, Jian Yu, Min Wang, Jiahong Lu, Chongbo Zhao, Tiansong Zhang, Chao Quan
A large-scale review study of pregnancy-related attacks in NMOSD patients
This study reviewed findings from multiple previous studies to understand how NMOSD patients fare during and around pregnancy, including the risk of relapses, disability changes, any pregnancy complications because of NMOSD, and the health status of the fetus/baby.
The researchers analyzed 15 studies that included 443 patients with NMOSD and a total of 639 pregnancies.
Patients who continued receiving immunosuppressive treatment and those who received at the age of 32 years or older were less likely to have an NMOSD attack during pregnancy. The risk of relapse was highest in the first 3 months after delivery (postpartum period).
The study also looked at disability, which is often linked to NMOSD relapses. Compared to before pregnancy, patients experienced higher levels of disability during pregnancy, and this status continued to worsen in the postpartum period.
Among 619 pregnancies with available data, about 64% resulted in full-term births. Further, about 23% cases had miscarriages or abortions, 5% had premature births, and 3% had complications during pregnancy. About 5% of babies had health complications.
Overall, the study suggests that pregnancy in people with NMOSD should be considered high risk. However, appropriate treatment during pregnancy may help reduce the risk of relapses and result in a full-term birth, especially in the period after delivery.
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