High risk of postpartum relapses in neuromyelitis optica spectrum disorder
High risk of postpartum relapses in neuromyelitis optica spectrum disorder
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DOI：
10.1212/wnl.0000000000004681
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发表时间：
2017-11-28
期刊：
影响因子：
9.9
通讯作者：
Weinshenker, Brian
中科院分区：
文献类型：
--
作者：
Klawiter, Eric C.;Bove, Riley;Weinshenker, Brian
目的：为了研究的影响，怀孕的频率上的视神经肌萎缩症（NMOSD）复发和评估率的妊娠相关并发症在国际多中心setting.Methods：我们管理的标准化调查，217名妇女与NMOSD从7个医疗中心，并回顾了他们的医疗记录。我们比较了参与者第一次怀孕前2年基线期的年复发率（ARR）与怀孕期间和产后9个月的年复发率。我们还评估了妊娠相关的complications.Results：有46信息怀孕后的症状发作在31名妇女NMOSD。与基线（0.17）相比，ARR在妊娠期间（0.44; p = 0.035）和产后期间（0.69; p = 0.009）均增加。最高的ARR发生在产后的前3个月（ARR 1.33）。共有8的76（10.5%）NMOSD发病前40岁经历了他们的初始症状在产后3个月，2.9倍高于expected.Conclusions：产后期间是一个特别高的风险时间为NMOSD的初始介绍。与已发表的多发性硬化症的观察结果相反，在视神经肌萎缩症中，妊娠期间的复发率也增加了，尽管程度低于分娩后。
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.