Evidence map›Paper›PMID 31948997›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2020

Pregnancy outcomes in anti-NMDA receptor encephalitis: Case series.

Bastien Joubert, Anna García-Serra, Jesús Planagumà, Eugenia Martínez-Hernandez, Andrea Kraft, Frederick Palm, Takahiro Iizuka, Jérôme Honnorat, Frank Leypoldt, Francesc Graus and 1 more

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Article in Neurology(R) neuroimmunology & neuroinflammation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Perinatal outcome in anti-NMDAr encephalitis during pregnancy-a systematic review with individual patients' data analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Bastien JoubertFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.ORCID 0000-0003-4631-3056
Anna García-SerraFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.ORCID 0000-0002-9609-2290
Jesús PlanagumàFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Eugenia Martínez-HernandezFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Andrea KraftFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Frederick PalmFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Takahiro IizukaFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Jérôme HonnoratFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Frank LeypoldtFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Francesc GrausFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA.
Josep DalmauFrom the Neuroimmunology Program (B.J., A.G.-S., J.P., E.M.-H., F.G., J.D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Spain; Department of Neurology (A.K.), Martha-Maria Hospital, Halle, Germany; Department of Neurology (F.P.), Helios Hospital, Schleswig, Germany; Department of Neurology (T.I.), Kitasato University School of Medicine, Sagamihara, Japan; French Reference Center on Paraneoplastic Neurological Syndromes (B.J., J.H.), Hospices Civils de Lyon, SynatAc Team, Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1; France; Neuroimmunology Section (F.L.), Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany; Department of Neurology (F.L.), Christian-Albrechts-University, Kiel, Germany; Institució Catalana de Recerca i Estudis Avançats (ICREA) (J.D.), Barcelona, Spain; and Department of Neurology (J.D.), University of Pennsylvania, PA. jdalmau@clinic.cat.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo report the effects of anti-NMDA receptor (NMDAR) encephalitis in pregnant patients and their babies.

methodsWe studied a retrospective cohort of patients who developed anti-NMDAR encephalitis during pregnancy or became pregnant while recovering from the encephalitis. In addition, we reviewed the English literature between 2010 and 2019 related to this topic.

resultsWe studied 11 patients; 6 developed anti-NMDAR encephalitis during pregnancy, and 5 became pregnant while recovering. There were no obstetrical complications, but 6 (55%) babies were premature. Ten newborns were healthy, and 1 (9%) developed transient respiratory distress. Nine infants had assessable follow-up (median 18 months; range, 7-96 months), and all showed normal development. We identified 21 cases in the English literature. Obstetrical complications occurred in 7 (33%) pregnancies. Two patients died of septic shock (1 baby successfully delivered), another 2 had miscarriages, and in 2, the pregnancy was terminated. Sixteen babies (76%) were delivered, 9 (56%) premature. At birth, 13/16 (81%) newborns were healthy, 2/16 (13%) had transient neurologic or respiratory symptoms, and 1 (6%) died of brain edema. Follow-up (median 12 months; range, 6-36 months) was reported for 8 children: 7 (88%) showed normal development and behavior, and 1 (13%) cortical dysplasia. Immunotherapy was used during pregnancy in 7 (64%) of our patients and 18 (86%) of the reported cases, including rituximab in 4 cases, without adverse effects.

conclusionsPatients who develop anti-NMDAR encephalitis during pregnancy or become pregnant during recovery often have obstetrical complications, but most of the newborns are healthy and appear to have normal development.

Indexed as

AdolescentAdultAnti-N-Methyl-D-Aspartate Receptor EncephalitisFemaleHumansInfant, NewbornObstetric Labor ComplicationsPregnancyPregnancy ComplicationsPregnancy OutcomeRetrospective StudiesYoung Adult

Identifiers

PMID31948997
PMCPMC7051205

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