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Pregnancy characteristics in Egyptian female patients with NMOSD
Adel Hassanein Gad1, Nirmeen Kishk1, Nevin M Shalaby1
1Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Background:
Neuromyelitis optica spectrum disorder (NMOSD) primarily affects women of childbearing age.
Objectives:
Studying the potential relationship between NMOSD and pregnancy characteristics and outcomes.
Subjects And Methods:
This is a retrospective cohort study that was conducted on 66 married female patients diagnosed with NMOSD. All patients underwent a thorough review of their demographic and clinical history through their medical records and personal interviews. Additionally, a complete neurological examination was performed, along with the expanded disability status scale (EDSS) and a pregnancy registry questionnaire.
Results:
After comparing married patients before and after disease onset, there was a significant increase in the number of abortions and the percentage of cesarean sections, as well as a decrease in the percentage of breastfeeding after disease onset. The p values were .02, <.001, and <.001, respectively, with odds ratios of 2.03, 5.13, and 6.17. Additionally, there was a rise in the occurrence of postpartum relapses, which accounted for 66% of all relapses after the disease onset. Most of these relapses (88.7%) occurred within the first 3 months postpartum.
Conclusion:
Presence of NMOSD increased the percentage of miscarriage, delivery by cesarean section, and decreased the chance of breastfeeding. In addition, pregnancy increases NMOSD relapse and subsequent disability.
