Pregnancy and antibody-mediated CNS disorders: What do we know and what should we know?
Antibody-mediated central nervous system (CNS) disorders including those associated with aquaporin-4 or myelin oligodendrocyte glycoprotein IgG and autoimmune encephalitis often affect women of childbearing age. Pathogenic antibodies of these diseases can potentially alter reproductive functions and...
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| Veröffentlicht in: | Frontiers in neurology Jg. 13; S. 1048502 |
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| Format: | Journal Article |
| Sprache: | Englisch |
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19.12.2022
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| Abstract | Antibody-mediated central nervous system (CNS) disorders including those associated with aquaporin-4 or myelin oligodendrocyte glycoprotein IgG and autoimmune encephalitis often affect women of childbearing age. Pathogenic antibodies of these diseases can potentially alter reproductive functions and influence fetal development. Hormonal changes occurring during pregnancy may modify the course of autoimmune diseases by influencing relapse risk, attack severity, and affect the delivery and postpartum period. Moreover, balancing treatment related safety issues with the risk of potentially disabling relapses during pregnancy and breastfeeding are major challenges. Intentional prenatal, gestational, and post-partum counseling is paramount to address these issues and mitigate these risks. Fortunately, new insights on risk factors for adverse pregnancy outcomes and possible preventive strategies are emerging. This review aims to summarize the interplay between antibody-mediated CNS disorders and pregnancy during the prenatal, gestational, and postpartum periods, highlight current treatment recommendations, and discuss future areas of research. |
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| AbstractList | Antibody-mediated central nervous system (CNS) disorders including those associated with aquaporin-4 or myelin oligodendrocyte glycoprotein IgG and autoimmune encephalitis often affect women of childbearing age. Pathogenic antibodies of these diseases can potentially alter reproductive functions and influence fetal development. Hormonal changes occurring during pregnancy may modify the course of autoimmune diseases by influencing relapse risk, attack severity, and affect the delivery and postpartum period. Moreover, balancing treatment related safety issues with the risk of potentially disabling relapses during pregnancy and breastfeeding are major challenges. Intentional prenatal, gestational, and post-partum counseling is paramount to address these issues and mitigate these risks. Fortunately, new insights on risk factors for adverse pregnancy outcomes and possible preventive strategies are emerging. This review aims to summarize the interplay between antibody-mediated CNS disorders and pregnancy during the prenatal, gestational, and postpartum periods, highlight current treatment recommendations, and discuss future areas of research. Antibody-mediated central nervous system (CNS) disorders including those associated with aquaporin-4 or myelin oligodendrocyte glycoprotein IgG and autoimmune encephalitis often affect women of childbearing age. Pathogenic antibodies of these diseases can potentially alter reproductive functions and influence fetal development. Hormonal changes occurring during pregnancy may modify the course of autoimmune diseases by influencing relapse risk, attack severity, and affect the delivery and postpartum period. Moreover, balancing treatment related safety issues with the risk of potentially disabling relapses during pregnancy and breastfeeding are major challenges. Intentional prenatal, gestational, and post-partum counseling is paramount to address these issues and mitigate these risks. Fortunately, new insights on risk factors for adverse pregnancy outcomes and possible preventive strategies are emerging. This review aims to summarize the interplay between antibody-mediated CNS disorders and pregnancy during the prenatal, gestational, and postpartum periods, highlight current treatment recommendations, and discuss future areas of research.Antibody-mediated central nervous system (CNS) disorders including those associated with aquaporin-4 or myelin oligodendrocyte glycoprotein IgG and autoimmune encephalitis often affect women of childbearing age. Pathogenic antibodies of these diseases can potentially alter reproductive functions and influence fetal development. Hormonal changes occurring during pregnancy may modify the course of autoimmune diseases by influencing relapse risk, attack severity, and affect the delivery and postpartum period. Moreover, balancing treatment related safety issues with the risk of potentially disabling relapses during pregnancy and breastfeeding are major challenges. Intentional prenatal, gestational, and post-partum counseling is paramount to address these issues and mitigate these risks. Fortunately, new insights on risk factors for adverse pregnancy outcomes and possible preventive strategies are emerging. This review aims to summarize the interplay between antibody-mediated CNS disorders and pregnancy during the prenatal, gestational, and postpartum periods, highlight current treatment recommendations, and discuss future areas of research. |
| Author | Cortese, Rosa Mancinelli, Chiara Rosa Mariotto, Sara Tortorella, Carla |
| AuthorAffiliation | 1 Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy 2 Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona , Verona , Italy 3 Multiple Sclerosis Center, Spedali Civili of Brescia , Brescia , Italy 4 Department of Neurosciences, S. Camillo-Forlanini Hospital , Rome , Italy |
| AuthorAffiliation_xml | – name: 4 Department of Neurosciences, S. Camillo-Forlanini Hospital , Rome , Italy – name: 2 Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona , Verona , Italy – name: 1 Department of Medicine, Surgery and Neuroscience, University of Siena , Siena , Italy – name: 3 Multiple Sclerosis Center, Spedali Civili of Brescia , Brescia , Italy |
| Author_xml | – sequence: 1 givenname: Rosa surname: Cortese fullname: Cortese, Rosa – sequence: 2 givenname: Sara surname: Mariotto fullname: Mariotto, Sara – sequence: 3 givenname: Chiara Rosa surname: Mancinelli fullname: Mancinelli, Chiara Rosa – sequence: 4 givenname: Carla surname: Tortorella fullname: Tortorella, Carla |
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| Keywords | autoimmune encephalitis postpartum breastfeeding neuromyelitis optica spectrum disorders (not in MeSH) myelin oligodendrocyte (MOG) antibody associated disease pregnancy |
| Language | English |
| License | Copyright © 2022 Cortese, Mariotto, Mancinelli and Tortorella. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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