在NMDAR抗体脑炎和怀孕中的临床数据和报告质量:系统性审查
Scarlett L Harris1,2, Sophie N M Binks3,4, Donal Skelly4,5
1Medical Sciences Division, University of Oxford, Oxford, UK.
BMJ neurology open
|March 5, 2025
概括
在怀孕期间的N-甲基-D-酸盐受体抗体脑炎 (NMDAR-Ab-E) 一般显示出令人放心的母婴结局. 然而,需要更多的标准化,多中心数据来确认安全性和长期影响.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 生殖医学 生殖医学
背景情况:
- N-甲基-D-酸盐受体抗体脑炎 (NMDAR-Ab-E) 可以在怀孕前,怀孕期间或怀孕后发生.
- 动物模型表明,体外抗体转移可能会影响神经发育.
- 在怀孕期间关于NMDAR-Ab-E的临床报告在很大程度上令人放心.
研究的目的:
- 系统地审查NMDAR-Ab-E.的孕产妇,婴儿和儿童期结果.
- 将这些结果与来自单一自身免疫神经病学中心的数据进行比较.
- 评估NMDAR-Ab-E对怀孕和后代的影响.
主要方法:
- 在PubMed和Scopus上对与怀孕相关的NMDAR-Ab-E病例进行系统的文献搜索.
- 包括病例报告和系列在怀孕前,怀孕期间或怀孕后发病.
- 使用标准化检查清单提取孕产妇,新生儿和儿童期结局.
主要成果:
- 从48份报告中确定了61名妇女的66例怀孕.
- 72%的母亲在神经缺陷很小或没有神经缺陷的情况下恢复.
- 80%的怀孕导致活产;新生儿结局数据经常缺失.
结论:
- 总的来说,NMDAR-Ab-E似乎不会导致对母亲,胎儿或儿童不利的结果.
- 目前的证据受到小样本大小,缺乏标准化和不完整的后续数据的限制.
- 建议多中心合作和国际注册表用于未来的研究.
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