Researchers explored the association between pregnancy and the development and course of neuromyelitis optica spectrum disorder (NMOSD) in women of childbearing age and published their findings in Clinical Neurology and Neurosurgery.

They found no effect of pregnancy prior to disease onset, however, in younger patients, pregnancy might be a trigger for the onset of NMOSD in those women with early onset of the condition.

“Given that NMOSD mostly targets females of childbearing age, different researchers have investigated the link between pregnancy and NMOSD activity in recent years,” the authors wrote.

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“This study aimed to describe the pregnancy and childbirth status of women with NMOSD and evaluate the potential effects of preceding pregnancies on the onset and disease course.”

The research team conducted a retrospective, observational study on 69 women with NMOSD from a single center in Tehran, Iran, between August and October of 2019. The authors collected data on the patients’ reproductive history and analyzed the association between pregnancy-related factors and age of onset, attack rate, and disability status.

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The results showed that in patients with a prior pregnancy, the age at the first attack was significantly higher than in those without pregnancy. Pregnancy did not affect the time of NMOSD onset, but over 25% of those with pregnancy prior to NMOSD had their first attack within 12 months of delivery. Furthermore, those who were younger at NMOSD onset had a shorter time interval between their first pregnancy and first attack.

Given that the data show that in younger patients pregnancy is a possible trigger for NMOSD relapses, the authors recommend further studies exploring the effect of pregnancy and hormones on the risk and onset of NMOSD.


Hadinejad M, Masoudi M, Saharaian MA, et al. Exploring the association of reproductive history with the development and course of neuromyelitis optica spectrum disorder. Clin Neurol Neurosurg. Published online June 18, 2022. doi:10.1016/j.clineuro.2022.107342