Obstetric outcomes in a Mexican cohort of patients with AQP4-antibody-seropositive neuromyelitis optica

•Close to half of the patients with previous pregnancies reported at least one gestational loss. This percentage is higher than expected for their age group in our country.•Most of these pregnancy losses occurred years before the diagnosis of NMO.•AQP4-IgG can be detected in serum more than 10 years...

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Published in:Multiple sclerosis and related disorders 2018-10, Vol.25, p.268-270
Main Authors: Delgado-García, Guillermo, Chávez, Zoé, Rivas-Alonso, Verónica, Corona, Teresa, Flores-Rivera, José
Format: Article
Language:English
Subjects:
Abortion
Adult
Aquaporin 4
Aquaporin 4 - immunology
Autoantibodies - blood
Female
Hispanics
Humans
Immunologic Factors - adverse effects
Mexico - epidemiology
Middle Aged
Neuromyelitis optica
Neuromyelitis Optica - blood
Neuromyelitis Optica - complications
Neuromyelitis Optica - drug therapy
Obstetric Labor Complications - epidemiology
Obstetric Labor Complications - etiology
Pregnancy
Pregnancy complications
Pregnancy outcome
Spontaneous abortion
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Summary:•Close to half of the patients with previous pregnancies reported at least one gestational loss. This percentage is higher than expected for their age group in our country.•Most of these pregnancy losses occurred years before the diagnosis of NMO.•AQP4-IgG can be detected in serum more than 10 years before the NMO onset and can cause miscarriage by binding to placental AQP4, activating complement, and causing inflammatory infiltration. Background: Previous studies have investigated the influence of neuromyelitis optica (NMO) on pregnancy in other ethnic groups. However, there are potential variations among ethnic groups. The obstetric outcome of Mexican patients with NMO and AQP4-IgG positivity (AQP4-IgG[+]) is currently unknown. Objective: To describe the obstetric history of Mexican patients with NMO and AQP4-IgG(+). Methods: Patients with NMO and AQP4-IgG(+) were identified from the database of the Demyelinating Diseases Clinic. These patients were interviewed by telephone. Results: Out of a total of 40 eligible patients, 29 were contacted and completed the survey. Of these, 19 patients reported at least one previous pregnancy. In total, 50 pregnancies were reported: 44 of them occurred ≥ 3 years before the first clinical manifestation, 1 occurred ≥ 1 years before, and 1 occurred after the first manifestation. Of all pregnancies, 12 were pregnancy losses: 5 were classified as miscarriages and 3 as stillbirths. Of all pregnancy losses, 10 occurred ≥ 3 years before the diagnosis, 1 occurred after the first manifestation. All pregnancy losses occurred in 8 patients. Conclusions: Close to half of the patients with previous pregnancies reported at least one pregnancy loss, most of these occurred ≥ 3 years before the diagnosis. This percentage is higher than expected for their age group in our country.
ISSN:2211-0348
2211-0356
DOI:10.1016/j.msard.2018.08.015