Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune condition that affects the central nervous system and can be particularly dangerous in pregnant women. The effects of NMOSD can be harmful to both the mother and the fetus, with an increased risk of relapse and disability.
While immunosuppressive therapy is the cornerstone of treatment for pregnant women with NMOSD, few studies have assessed the benefits and risks of immunosuppressive therapy in this population. Along the same lines, few studies have investigated the predictive factors for pregnancy-related attacks.
A meta-analysis published in Frontiers in Immunology assessed data on the characteristics and outcomes of pregnant women with NMOSD. Included in the meta-analysis were seven studies that were either cohort studies or case series. Two reviewers independently searched and screened articles pulled from PubMed, Embase, and Cochrane Library.
Ultimately, more pregnancy-related attacks were seen in patients with a shorter time interval between their last relapse and conception. Moreover, pregnant women with NMOSD who were treated with immunosuppressive therapy experienced significantly fewer relapses and pregnancy-related attacks, although immunosuppressive therapy may increase the risk of poor health in newborns.
In conclusion, healthcare providers should take special care to ensure that pregnant women with NMOSD are treated appropriately to prevent pregnancy-related attacks. Healthcare providers should also consider the dosage and risks of maintenance treatment with immunosuppressive therapy when considering relapse and potential adverse effects on the fetus .
Source: Deng, S., Lei, Q., & Lu, W. (2022). Pregnancy-related attack in neuromyelitis optica spectrum disorder with AQP4-IgG: a single-center study and meta-analysis. Frontiers in Immunology, 12. https://doi.org/10.3389/fimmu.2021.800666