Pregnancy in women with Neuromyelitis Optica Spectrum Disorders: Recommendations from the French Multiple Sclerosis Society (P13-4.006)

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Vukusic, Sandra | Ciron, Jonathan | Carra-Dalliere, Clarisse | Maillart, Elisabeth | Michel, Laure | Leray, Emmanuelle | Guennoc, Anne Marie | Bourre, Bertrand | Laplaud, David | Androdias-Condemine, Geraldine | Bensa, Caroline | Bigaut, Kevin | Biotti, Damien | Branger, Pierre | Casez, Olivier | Cohen, Mikael | Daval, Elodie | Deschamps, Romain | Donzé, Cécile | Dubessy, Anne-Laure | Dulau, Cécile | Durand-Dubief, Françoise | Guillaume, Maxime | Hebant, Benjamin | Kremer, Laurent | Kwiatkowski, Arnaud | Lannoy, Julien | Maarouf, Adil | Manchon, Eric | Mathey, Guillaume | Moisset, Xavier | Montcuquet, Alexis | Pique, Julie | Roux, Thomas | Marignier, Romain | Lebrun-Frenay, Christine

Edité par CCSD ; American Academy of Neurology -

International audience. 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.

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