JNNP: Optic neuroscolitis spectrum disorder: pregnancy-related seizures and predictive risk factors

Optic neurospinalitis spectrum disorder (NMOSD) reflects the classification of inflammatory diseases of the central nervous system (CNS) induced by autoantibodies, mainly related to optic nerves, spinal cord, the presence of pathogenic water channel protein-4 antibodies (AQP4-ab) in the serum is highly specific to NMOSD, in most NMOSD patients have such findings.
also recently detected serum myelin-less protrusive glial glial glycoprotein antibodies (MOG-ab) in some patients with AQP4-ab-negative NMOSD.
NMOSD mainly affects women, clinical and experimental studies have shown that AQP4 is expressed on the placenta in humans and animals and may lead to placental inflammation and fetal death.
this paper explores the effects of pregnancy on patients with optic neuroscolonitis spectrum disorder (NMOSD) and the risk factors for predicting pregnancy-related onset.
: From January 2015 to April 2019, Huashan Hospital treated 418 female NMOSD patients.
reviewed their medical records and found 110 cases of 136 patients with data-related pregnancies, of which 83 were positive for water channel protein 4 antibodies (aqp4ab) and 21 were positive for myelin less protrusion glial cytosebulin antibodies.
pregnancy-related seizures are defined as seizures that occur during pregnancy or within one year of childbirth/abortion.
the annualized recurrence rate (ARR) for the first 12 months of pregnancy with the recurrence rate for each pregnancy period and after delivery/abortion.
multivariate analysis is used to explore relevant independent risk factors and generate a column chart to predict pregnancy-related seizures.
35 female patients from three other centers formed an external queue to verify the line chart.
results: significantly higher ARR in the early stages of pregnancy (p.lt;0.001) or miscarriage (p.019) compared to pre-pregnancy.
independent risk factors for predicting pregnancy-related seizures include age at birth/abortion (20-26.5, p=0.018; 26.5-33, p=0.001), AQP4 antibody titration (≥1:100, p=0.049) and inappropriate treatment during pregnancy and post-natal care (p=0.004).
in internal and external validation, bootstrap resampling is used, and the consistency indices of the line charts are 0.87 and 0.77, respectively.
: Early pregnancy is a high-risk period for NMOSD recurrence.
the younger the patient, the higher the AQP4 antibody titration, and the higher the risk of pregnancy-related diseases in patients with improper treatment.
Wang L, Zhou L, Zhang Bao J, et al Neuromyelitis optica spectrum disorder: pregnancy-related attack and predictive risk factors Journal of Neurology, Neurosurgery and Psython Published Online First: 20 November 2020. doi: 10.1136/jnnp-2020-323982MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Met Medical" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual. Source: Mays Medicine.
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