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Neuromyelitis optica spectrum disorders and pregnancy: therapeutic considerations.
Nature Reviews Neurology ( IF 28.2 ) Pub Date : 2020-02-20 , DOI: 10.1038/s41582-020-0313-y Yang Mao-Draayer 1, 2 , Sandra Thiel 3 , Elizabeth A Mills 1 , Tanuja Chitnis 4 , Michelle Fabian 5 , Ilana Katz Sand 5 , M Isabel Leite 6 , Sven Jarius 7 , Kerstin Hellwig 3
Nature Reviews Neurology ( IF 28.2 ) Pub Date : 2020-02-20 , DOI: 10.1038/s41582-020-0313-y Yang Mao-Draayer 1, 2 , Sandra Thiel 3 , Elizabeth A Mills 1 , Tanuja Chitnis 4 , Michelle Fabian 5 , Ilana Katz Sand 5 , M Isabel Leite 6 , Sven Jarius 7 , Kerstin Hellwig 3
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Neuromyelitis optica spectrum disorders (NMOSD) are a type of neurological autoimmune disease characterized by attacks of CNS inflammation that are often severe and predominantly affect the spinal cord and optic nerve. The majority of individuals with NMOSD are women, many of whom are of childbearing age. Although NMOSD are rare, several small retrospective studies and case reports have indicated that pregnancy can worsen disease activity and might contribute to disease onset. NMOSD disease activity seems to negatively affect pregnancy outcomes. Moreover, some of the current NMOSD treatments are known to pose risks to the developing fetus and only limited safety data are available for others. Here, we review published studies regarding the relationship between pregnancy outcomes and NMOSD disease activity. We also assess the risks associated with using disease-modifying therapies for NMOSD during the course of pregnancy and breastfeeding. On the basis of the available evidence, we offer recommendations regarding the use of these therapies in the course of pregnancy planning in individuals with NMOSD.
中文翻译：
视神经脊髓炎频谱疾病和妊娠：治疗上的考虑。
视神经脊髓炎光谱疾病（NMOSD）是一种神经系统自身免疫性疾病，其特征是中枢神经系统炎症的发作，这种发作通常很严重，主要影响脊髓和视神经。NMOSD的大多数人是女性，其中许多是育龄的。尽管NMOSD很少见，但一些小型回顾性研究和病例报告表明，怀孕会使疾病活动恶化，并可能导致疾病发作。NMOSD疾病活动似乎对妊娠结局产生负面影响。此外，已知一些当前的NMOSD治疗会对胎儿发育带来风险，而其他人只能获得有限的安全性数据。在这里，我们回顾了有关妊娠结局与NMOSD疾病活动之间关系的已发表研究。我们还评估了在妊娠和母乳喂养过程中使用针对NMOSD的疾病改良疗法相关的风险。在现有证据的基础上，我们提供有关在NMOSD患者怀孕计划过程中使用这些疗法的建议。
更新日期：2020-02-20
中文翻译：
视神经脊髓炎频谱疾病和妊娠：治疗上的考虑。
视神经脊髓炎光谱疾病（NMOSD）是一种神经系统自身免疫性疾病，其特征是中枢神经系统炎症的发作，这种发作通常很严重，主要影响脊髓和视神经。NMOSD的大多数人是女性，其中许多是育龄的。尽管NMOSD很少见，但一些小型回顾性研究和病例报告表明，怀孕会使疾病活动恶化，并可能导致疾病发作。NMOSD疾病活动似乎对妊娠结局产生负面影响。此外，已知一些当前的NMOSD治疗会对胎儿发育带来风险，而其他人只能获得有限的安全性数据。在这里，我们回顾了有关妊娠结局与NMOSD疾病活动之间关系的已发表研究。我们还评估了在妊娠和母乳喂养过程中使用针对NMOSD的疾病改良疗法相关的风险。在现有证据的基础上，我们提供有关在NMOSD患者怀孕计划过程中使用这些疗法的建议。
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