ArticleNeurology2016
Pregnancy outcomes in aquaporin-4-positive neuromyelitis optica spectrum disorder.
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Article in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
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49citing papers in PubMed, 4 pooled it
8.4field-weighted citation impact, top 2% of its field
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Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Consensus Recommendations for the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders (NMOSD): The MENACTRIMS Guidelines.CNS drugs · 2026Guideline
- Analysis of Pregnancy-Related Attacks in Neuromyelitis Optica Spectrum Disorder: A Systematic Review and Meta-Analysis.JAMA network open · 2022Pooled it
- Pregnancy-Related Attack in Neuromyelitis Optica Spectrum Disorder With AQP4-IgG: A Single-Center Study and Meta-Analysis.Frontiers in immunology · 2021Pooled it
- Pregnancy and Neuromyelitis Optica Spectrum Disorder - Reciprocal Effects and Practical Recommendations: A Systematic Review.Frontiers in neurology · 2020Pooled it
- Consensus statement for the diagnosis and management of optic neuritis.Indian journal of ophthalmology · 2026Review
- Controversies in neuroimmunology: Multiple sclerosis and other demyelinating disordersBiomedica : revista del Instituto Nacional de Salud · 2026Review
- Unexpected pregnancy in a patient with AQP4-IgG + NMOSD after treatment with inebilizumab: a case report.BMC neurology · 2026Article
- Case Report: Pharmacological decision-making in pregnant women with neuromyelitis optica spectrum disorder: two contrasting clinical scenarios.Frontiers in pharmacology · 2026Article
- Insights into neuromyelitis optica spectrum disorder and pregnancy from a single-center study in Thailand.Scientific reports · 2025Article
- Progress in the management of pregnancy in patients with neuromyelitis optica spectrum disorder.Therapeutic advances in neurological disorders · 2025Review
- Perinatal Management of Neuromyelitis Optica Spectrum Disorder in Pregnancy: A Case Report.International journal of women's health · 2025Article
- Sex hormones and neuromyelitis optica spectrum disorder: a bidirectional Mendelian randomization study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Neuromyelitis optica spectrum disorder: Exploring the diverse clinical manifestations and the need for further exploration.Brain and behavior · 2024Review
- A Narrative Review on Neuro-Ophthalmological Manifestations That May Occur during Pregnancy.Life (Basel, Switzerland) · 2024Review
- Pregnancy prevalence and outcomes after optic neuritis in South Korea.Scientific reports · 2023Article
- Cerebellar connectome alterations and associated genetic signatures in multiple sclerosis and neuromyelitis optica spectrum disorder.Journal of translational medicine · 2023Article
- Neuromyelitis optica spectrum disorder safely and successfully treated with satralizumab during pregnancy and breastfeeding: a case report.Frontiers in neurology · 2023Article
- Effects of pregnancy on neuromyelitis optica spectrum disorder and predictors of related attacks.Annals of clinical and translational neurology · 2022Article
- Contemporary management challenges in seropositive NMOSD.Journal of neurology · 2022Article
- In utero exposure to maternal anti-aquaporin-4 antibodies alters brain vasculature and neural dynamics in male mouse offspring.Science translational medicine · 2022Article
Corrections and comments
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Authors and funding
21 authors at 1 institution in 1 country.
Matthew M NourFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Ichiro NakashimaFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Ester CoutinhoFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Mark WoodhallFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Filipa SousaFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Jon RevisFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Yoshiki TakaiFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Jithin GeorgeFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Joanna KitleyFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Maria Ernestina SantosFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Joseph M NourFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Fan ChengFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Hiroshi KurodaFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Tatsuro MisuFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Ana Martins-da-SilvaFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Gabriele C DeLucaFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Angela VincentFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Jacqueline PalaceFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Patrick WatersFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Kazuo FujiharaFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal.
Maria Isabel LeiteFrom the Nuffield Department of Clinical Neurosciences (M.M.N., E.C., M.W., J.R., J.G., J.K., J.M.N., F.C., G.C.D., A.V., J.P., P.W., M.I.L.), John Radcliffe Hospital, University of Oxford, UK; Departments of Neurology (I.N., Y.T., H.K.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Clinical Neurology (F.S.), Hospital de São Marcos, Braga; and Department of Clinical Neurology (A.M.-d.-S., M.E.S.), Hospital Geral Santo Antonio, Porto, Portugal. maria.leite@ndcn.ox.ac.uk.
Tohoku University · JP
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the association between neuromyelitis optica spectrum disorder (NMOSD) and pregnancy outcome.
methodsAn international cohort of women with aquaporin-4 antibody-positive NMOSD and ≥1 pregnancy was studied retrospectively. Multivariate logistic regression was used to investigate whether pregnancy after NMOSD onset was associated with an increased risk of miscarriage (cohort of 40 women) or preeclampsia (cohort of 57 women).
resultsMiscarriage rate was higher in pregnancies after NMOSD onset (42.9% [95% confidence interval 17.7%-71.1%] vs. 7.04% [2.33%-15.7%]). Pregnancies conceived after, or up to 3 years before, NMOSD onset had an increased odds ratio of miscarriage (7.28 [1.03-51.6] and 11.6 [1.05-128], respectively), independent of maternal age or history of miscarriage. Pregnancies after, or up to 1 year before, NMOSD onset ending in miscarriage were associated with increased disease activity from 9 months before conception to the end of pregnancy, compared to viable pregnancies (mean annualized relapse rate 0.707 vs. 0.100). The preeclampsia rate (11.5% [6.27%-18.9%]) was significantly higher than reported in population studies. The odds of preeclampsia were greater in women with multiple other autoimmune disorders or miscarriage in the most recent previous pregnancy, but NMOSD onset was not a risk factor.
conclusionsPregnancy after NMOSD onset is an independent risk factor for miscarriage, and pregnancies conceived at times of high disease activity may be at increased risk of miscarriage. Women who develop NMOSD and have multiple other autoimmune disorders have greater odds of preeclampsia, independent of NMOSD onset timing.
Indexed as
Aquaporin 4Abortion, SpontaneousAdultAutoantibodiesCohort StudiesFemaleHumansInternationalityNeuromyelitis OpticaPre-EclampsiaPregnancyPregnancy ComplicationsPregnancy OutcomeRetrospective StudiesRisk FactorsAQP4 protein, humanAquaporin 4Autoantibodies
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