TY - JOUR
T1 - Risks and outcomes of pregnancy in neuromyelitis optica spectrum disorder
T2 - A comprehensive review
AU - Siriratnam, Pakeeran
AU - Huda, Saif
AU - Butzkueven, Helmut
AU - van der Walt, Anneke
AU - Jokubaitis, Vilija
AU - Monif, Mastura
N1 - Funding Information:
Pakeeran Siriratnam has received travel support from Novartis and Biogen. Saif Huda reports no relevant disclosures. Anneke van der Walt has received travel support and served on advisory boards for Novartis, Biogen, Merck Serono, Roche and Teva. She receives grant support from the National Health and Medical Research Council of Australia. Helmut Butzkueven served on scientific advisory boards for Biogen, Novartis and Sanofi-Aventis and received conference travel support from Novartis, Biogen and Sanofi Aventis. He serves on steering committees for trials conducted by Biogen and Novartis and received research support from Merck, Novartis and Biogen. Vilija Jokubaitis receives research grant support form F.Hoffmann La-Roche, MS Research Australia and the National Health and Medical Research Council of Australia (NHMRC 1156519 ). Mastura Monif has served on advisory board for Merck, and Novartis, and has received speaker honoraria from Merck, Biogen and Novartis. Her institution receives funding from Merck, Australian National Health Medical Research Council, and MS Research Australia.
Publisher Copyright:
© 2023 The Authors
PY - 2024/2
Y1 - 2024/2
N2 - Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system autoimmune disease. Aquaporin-4 antibody (AQP4-IgG) is present in over 75% of cases and criteria also exist for the diagnosis of seronegative NMOSD. AQP4-IgG NMOSD has a strong female predominance (9:1 ratio), with a median onset age of 40 years. Pregnancy in those with NMOSD is therefore an important topic. Fecundity in NMOSD is likely impaired, and for females who conceive, obstetric complications including miscarriages and pre-eclampsia are significantly higher in NMOSD compared to the general population and in related conditions such as multiple sclerosis (MS). In contrast to MS, NMOSD disease activity does not subside during pregnancy. Also, relapse risk substantially rises above pre-pregnancy rates in the early postpartum period. In view of the evolving landscape of NMOSD, we provide a contemporary update of the impacts of pregnancy in NMOSD.
AB - Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system autoimmune disease. Aquaporin-4 antibody (AQP4-IgG) is present in over 75% of cases and criteria also exist for the diagnosis of seronegative NMOSD. AQP4-IgG NMOSD has a strong female predominance (9:1 ratio), with a median onset age of 40 years. Pregnancy in those with NMOSD is therefore an important topic. Fecundity in NMOSD is likely impaired, and for females who conceive, obstetric complications including miscarriages and pre-eclampsia are significantly higher in NMOSD compared to the general population and in related conditions such as multiple sclerosis (MS). In contrast to MS, NMOSD disease activity does not subside during pregnancy. Also, relapse risk substantially rises above pre-pregnancy rates in the early postpartum period. In view of the evolving landscape of NMOSD, we provide a contemporary update of the impacts of pregnancy in NMOSD.
KW - Foetal outcomes
KW - Maternal risks
KW - NMOSD
KW - Obstetrics
KW - Pregnancy
KW - Relapses
UR - http://www.scopus.com/inward/record.url?scp=85179479500&partnerID=8YFLogxK
U2 - 10.1016/j.autrev.2023.103499
DO - 10.1016/j.autrev.2023.103499
M3 - Review Article
C2 - 38061621
AN - SCOPUS:85179479500
SN - 1568-9972
VL - 23
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
IS - 2
M1 - 103499
ER -