Neuromyelitis optica and pregnancy

    loading  Checking for direct PDF access through Ovid

Abstract

Objective:

The purpose of our study was to assess the influence of pregnancy on the course of neuromyelitis optica (NMO) and the impact of epidural analgesia and breastfeeding on its activity in the postpartum period.

Methods:

We performed a retrospective study of patients with NMO diagnosed according to Wingerchuk criteria. We noted the number of relapses during the year before pregnancy (BP), during pregnancy (first trimester, second trimester, third trimester), and the year after (Y + 1: first trimester, second trimester [PP2], and third and fourth trimesters postpartum). Epidural analgesia and breastfeeding were recorded. Disability was evaluated with the Kurtzke Expanded Disability Status Scale (EDSS). The annualized relapse rate (ARR) was calculated.

Results:

We identified 124 patients (85 female) in the French NOMADMUS cohort on November 1, 2010. A total of 20 women (including 25 pregnancies) were informative with complete files. Comparisons between the ARR of each period and BP (1.0 ± 0.09) only showed an increased tendency for PP2 (0.8 ± 0.06, p = 0.07). Epidural analgesia and breastfeeding had no influence on the course of NMO. The EDSS score increased from 1.5 ± 1.7 BP to 2.6 ± 1.9 Y + 1 (p = 0.027).

Conclusion:

This study shows that pregnancy influences the activity of NMO, a finding that justifies close medical monitoring. We found no evidence to suggest that either epidural analgesia or breastfeeding has an aggravating effect on NMO.

GLOSSARY

ARR: annualized relapse rate

GLOSSARY

BP: before pregnancy

GLOSSARY

EDMUS: European Database for MS

GLOSSARY

EDSS: Expanded Disability Status Scale

GLOSSARY

IgG: immunoglobulin G

GLOSSARY

MS: multiple sclerosis

GLOSSARY

NMO: neuromyelitis optica

GLOSSARY

NOMADMUS: European Database for MS adapted to neuromyelitis optica specificities

GLOSSARY

PP1: first trimester postpartum

GLOSSARY

PP2: second trimester postpartum

GLOSSARY

PP3: third trimester postpartum

GLOSSARY

PP4: fourth trimester postpartum

GLOSSARY

Y + 1: year after pregnancy.

Related Topics

    loading  Loading Related Articles