Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society - EHESP - École des hautes études en santé publique
Journal Articles Multiple Sclerosis Journal Year : 2023

Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society

Romain Marignier
Bertrand Bourre
Mikael Cohen
Maxime Guillaume
  • Function : Author
Anne-Marie Guennoc
  • Function : Author
David Laplaud
Géraldine Androdias
  • Function : Author
Caroline Bensa
  • Function : Author
Kevin Bigaut
Damien Biotti
Pierre Branger
  • Function : Author
Elodie Daval
  • Function : Author
Cécile Donze
  • Function : Author
Anne-Laure Dubessy
  • Function : Author
Arnaud Kwiatkowski
  • Function : Author
Cécile Dulau
  • Function : Author
Françoise Durand-Dubief
Benjamin Hebant
  • Function : Author
Julien Lannoy
  • Function : Author
Eric Manchon
  • Function : Author
Guillaume Mathey
  • Function : Author
Xavier Moisset
Alexis Montcuquet
  • Function : Author
Thomas Roux
Elisabeth Maillart
Christine Lebrun-Frenay

Abstract

Background: In 2020, the French Multiple Sclerosis (MS) Society (SFSEP) decided to develop a national evidence-based consensus on pregnancy in MS. As neuromyelitis optica spectrum disorders (NMOSD) shares a series of commonalities with MS, but also some significant differences, specific recommendations had to be developed.Objectives: To establish recommendations on pregnancy in women with NMOSD.Methods: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and universities databases (January 1975 through June 2021). The RAND/UCLA appropriateness method, which was developed to synthesise the scientific literature and expert opinions on health care topics, was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A sub-group of nine NMOSD experts was dedicated to analysing available data on NMOSD. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence.Results: A strong agreement was reached for all 66 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, loco-regional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses, and disease-modifying treatments.Conclusion: Physicians and patients should be aware of the new and specific evidence-based recommendations of the French MS Society for pregnancy in women with NMOSD. They should help harmonise counselling and treatment practise, allowing for better individualised choices.
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Dates and versions

hal-03871563 , version 1 (25-11-2022)

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Sandra Vukusic, Romain Marignier, Jonathan Ciron, Bertrand Bourre, Mikael Cohen, et al.. Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society. Multiple Sclerosis Journal, 2023, 29 (1), pp.37-51. ⟨10.1177/13524585221130934⟩. ⟨hal-03871563⟩
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