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Related Experiment Video

Updated: Nov 30, 2025

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

Published on: August 21, 2017

Pregnancy and Neuromyelitis Optica Spectrum Disorder - Reciprocal Effects and Practical Recommendations: A Systematic

Rohan D'Souza¹, Danielle Wuebbolt^1,2,3, Katarina Andrejevic^1,4

¹Division of Maternal and Fetal Medicine, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

Frontiers in Neurology

|November 12, 2020

Summary

Neuromyelitis optica spectrum disorder (NMOSD) can increase during pregnancy and postpartum. Aggressive treatment with immunosuppressants and corticosteroids is effective for managing NMOSD relapses in pregnant women.

Keywords:

devic syndrome maternal and fetal risks neuromyelitis optica spectrum disorder pregnancy systematic review

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Area of Science:

Neurology
Immunology
Reproductive Medicine

Background:

Neuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune CNS inflammatory condition.
Pregnancy in NMOSD patients is associated with potential risks and disease activity fluctuations.
Systematic review to guide management of pregnant NMOSD patients.

Approach:

Systematic review of 22 case reports and 7 case series.
Included 595 pregnancies in 389 women with NMOSD.
Data extraction and risk-of-bias assessment performed in duplicate.

Key Points:

NMOSD disease activity and relapses significantly increase during pregnancy and postpartum.
No significant increase in adverse obstetric outcomes like preterm birth or fetal growth restriction was observed.
Early pregnancy losses were reported but not definitively linked to NMOSD activity or treatment.

Conclusions:

Aggressive management with corticosteroids and immunosuppressants (e.g., azathioprine) is effective and safe during pregnancy and lactation.
Monoclonal antibodies show emerging safety data for use in pregnancy.
Intravenous immunoglobulin, plasma exchange, and immunoadsorption are safe options for severe relapses.