Increased relapse rate during pregnancy and postpartum in neuromyelitis optica


Neuromyelitis optica spectrum disorder (NMOSD) is a serious relapsing disease with a predilection for relapses in spinal cord and optic nerve. The presence of antibodies directed against the aquaporin-4 (AQP4) water channel has helped to distinguish NMOSD from multiple sclerosis (MS).1 A female preponderance exists in NMOSD and MS, although the overrepresentation of women in NMOSD is considerably greater, approaching a ratio of 8:1.2 The effect of pregnancy and the postpartum period on NMOSD disease expression and the effect of NMOSD on pregnancy outcomes are relatively unknown. In MS, reduced relapse rates during pregnancy, and a risk for increased relapse frequency in the first 3–6 months postpartum, are well-recognized.3 Such knowledge guides care for women during the preconception, intrapartum, and postpartum periods.


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