シミズ　ユウコ   SHIMIZU Yuko   清水　優子    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	総説
言語種別	日本語
査読の有無	査読なし
招待の有無	招待あり
表題	免疫性神経疾患の妊娠と出産update
掲載誌名	正式名：臨床神経学 ISSNコード：0009918X/18820654
掲載区分	国内
出版社	(一社)日本神経学会
巻・号・頁	52(11),878-881頁
著者・共著者	清水 優子
発行年月	2012/11
概要	To neurologists, pregnancy and delivery are major issues in patients with neuroimmunological diseases such as multiple sclerosis (MS), neuromyelitis optica (NMO), and myasthenia gravis (MG). The Pregnancy in Multiple Sclerosis Study reported that the annual relapse rate (ARR) decreases during pregnancy and increases during the first trimester after delivery. Discontinuation of interferon-β (IFNβ) is usually recommended prior to pregnancy. IFNβ exposure is related to lower birth weight, but no fetal complications or development abnormalities have been reported. Regarding pregnancy in NMO, our current study showed that the ARR during pregnancy was same as before pregnancy. A higher ARR was noted after delivery than in patients with MS. The numerous cases of NMO with onset after pregnancy suggest that delivery affects the exacerbation or of NMO. In women with MG, exacerbations occurred during approximately 30% of pregnancies, remission occurred in 30%, and 30% experienced no change. Exacerbations occurred in the first trimester and the three months postpartum. We must consider the risk of transient neonatal MG, because the frequency is 10-20% in infants born of MG mothers. It is especially important to carefully consider anti-MuSK antibody-positive patients because bulbar palsy is a major symptom.
DOI	10.5692/clinicalneurol.52.878
文献番号	2013116459
PMID	23196450