Abstract
OBJECTIVE: To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting.
METHODS: We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications.
RESULTS: There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected.
CONCLUSIONS: The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2238-2244 |
| Number of pages | 7 |
| Journal | Neurology |
| Volume | 89 |
| Issue number | 22 |
| DOIs | |
| State | Published - Nov 28 2017 |
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ASJC Scopus subject areas
- Clinical Neurology
Cite this
High risk of postpartum relapses in neuromyelitis optica spectrum disorder. / Klawiter, Eric C.; Bove, Riley; Elsone, Liene; Alvarez, Enrique; Borisow, Nadja; Cortez, Melissa; Mateen, Farrah; Mealy, Maureen A.; Sorum, Jaime; Mutch, Kerry; Tobyne, Sean M.; Ruprecht, Klemens; Buckle, Guy; Levy, Michael; Wingerchuk, Dean Marko; Paul, Friedemann; Cross, Anne H.; Jacobs, Anu; Chitnis, Tanuja; Weinshenker, Brian G.
In: Neurology, Vol. 89, No. 22, 28.11.2017, p. 2238-2244.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High risk of postpartum relapses in neuromyelitis optica spectrum disorder
AU - Klawiter, Eric C.
AU - Bove, Riley
AU - Elsone, Liene
AU - Alvarez, Enrique
AU - Borisow, Nadja
AU - Cortez, Melissa
AU - Mateen, Farrah
AU - Mealy, Maureen A.
AU - Sorum, Jaime
AU - Mutch, Kerry
AU - Tobyne, Sean M.
AU - Ruprecht, Klemens
AU - Buckle, Guy
AU - Levy, Michael
AU - Wingerchuk, Dean Marko
AU - Paul, Friedemann
AU - Cross, Anne H.
AU - Jacobs, Anu
AU - Chitnis, Tanuja
AU - Weinshenker, Brian G
PY - 2017/11/28
Y1 - 2017/11/28
N2 - OBJECTIVE: To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting.METHODS: We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications.RESULTS: There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected.CONCLUSIONS: The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery.
AB - OBJECTIVE: To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting.METHODS: We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications.RESULTS: There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected.CONCLUSIONS: The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery.
UR - http://www.scopus.com/inward/record.url?scp=85037972706&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85037972706&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000004681
DO - 10.1212/WNL.0000000000004681
M3 - Article
C2 - 29093070
AN - SCOPUS:85037972706
VL - 89
SP - 2238
EP - 2244
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 22
ER -