Pregnancy in women with Neuromyelitis Optica Spectrum Disorders: Recommendations from the French Multiple Sclerosis Society (P13-4.006)
Résumé
Objective: To establish recommendations on pregnancy in women with neuromyelitis optica spectrum disorders (NMOSD).Background: In 2020, the French Multiple Sclerosis (MS) Society (SFSEP) decided to develop a national evidence-based consensus on pregnancy in MS. As NMOSD and MOG-antibody associated disease (MOGAD) share a series of commonalities with MS, and some significant differences about that topic, specific recommendations had to be developed.Design/Methods: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed articles from PubMed and universities databases (January 1975 through December 2020). The RAND/UCLA appropriateness method, which was developed to synthesize the scientific literature and expert opinions on health care topics, was used to reach a formal agreement. 58 MS experts worked on the full-text review and initial wording of recommendations. A sub-group of 9 NMOSD experts was dedicated to analyzing of available data on NMOSD and MOGAD. A group of multidisciplinary healthcare specialists validated the final proposal of summarized evidences.Results: A strong agreement was reached for all 66 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and in the post-partum, delivery routes, loco-regional analgesia or anesthesia, prevention of post-partum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses, and disease-modifying treatments. Details will be presented at the AAN congress.Conclusions: Physicians and patients should be aware of the new evidence-based recommendations of the French MS Society for pregnancy in women with NMOSD and MOGAD.