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Perinatal outcome in anti-NMDAr encephalitis during pregnancy—a systematic review with individual patients' data analysis.

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Title: Perinatal outcome in anti-NMDAr encephalitis during pregnancy—a systematic review with individual patients' data analysis.
Authors: Scorrano, Giovanna (AUTHOR), Dono, Fedele (AUTHOR), Corniello, Clarissa (AUTHOR), Consoli, Stefano (AUTHOR), Evangelista, Giacomo (AUTHOR), Di Ludovico, Armando (AUTHOR), Chiarelli, Francesco (AUTHOR), Anzellotti, Francesca (AUTHOR), Di Iorio, Angelo (AUTHOR), Sensi, Stefano L. (AUTHOR)
Source: Neurological Sciences. Sep2024, Vol. 45 Issue 9, p4211-4227. 17p.
Subjects: Duration of pregnancy, Low birth weight, Pregnant women, Movement disorders, Symptoms, Anti-NMDA receptor encephalitis
Abstract: Introduction: Anti-N-methyl-D-aspartate receptor (NMDAr) antibody encephalitis is an autoimmune disorder characterized by synaptic NMDAr current disruption and receptor hypofunction, often affecting women during pregnancy. Clinical manifestations associated with anti-NMDAr encephalitis can occur both in the mother and fetus. Methods: We generated a systematic search of the literature to identify epidemiological, clinical, and serological data related to pregnant women with anti-NMDAr encephalitis and their children, analyzing the fetal outcomes. We examined the age and neurologic symptoms of the mothers, the presence of an underlying tumor, immunotherapies used during pregnancy, duration of the pregnancy, and type of delivery. Results: Data from 41 patients were extrapolated from the included studies. Spontaneous interruption of pregnancy, premature birth, and cesarean section were reported in pregnant women with NMDAr encephalitis. Several fetal and neonatal symptoms (e.g., movement disorders, spina bifida, poor sucking, respiratory distress, cardiac arrhythmias, infections, icterus, hypoglycemia, and low birth weight) depending on the mother's serum anti-NR1 concentration were also reported. Conclusions: We characterized the outcomes of children born from mothers with anti-NMDAr encephalitis, analyzing the pivotal risk factors related to pregnancy and maternal disorder. Neuropsychiatric involvement seems strictly related to pathogenic NMDAr antibodies detected in maternal and/or neonatal serum. These findings clarify a complex condition to manage, outlining the risks associated with pregnant women with anti-NMDAr encephalitis and also providing a concrete guide for therapeutic strategies to prevent potential harm to the fetus and the child's neurodevelopment. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Perinatal outcome in anti-NMDAr encephalitis during pregnancy—a systematic review with individual patients' data analysis.
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  Data: <searchLink fieldCode="AR" term="%22Scorrano%2C+Giovanna%22">Scorrano, Giovanna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dono%2C+Fedele%22">Dono, Fedele</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Corniello%2C+Clarissa%22">Corniello, Clarissa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Consoli%2C+Stefano%22">Consoli, Stefano</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Evangelista%2C+Giacomo%22">Evangelista, Giacomo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Di+Ludovico%2C+Armando%22">Di Ludovico, Armando</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chiarelli%2C+Francesco%22">Chiarelli, Francesco</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Anzellotti%2C+Francesca%22">Anzellotti, Francesca</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Di+Iorio%2C+Angelo%22">Di Iorio, Angelo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sensi%2C+Stefano+L%2E%22">Sensi, Stefano L.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Sep2024, Vol. 45 Issue 9, p4211-4227. 17p.
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  Data: <searchLink fieldCode="DE" term="%22Duration+of+pregnancy%22">Duration of pregnancy</searchLink><br /><searchLink fieldCode="DE" term="%22Low+birth+weight%22">Low birth weight</searchLink><br /><searchLink fieldCode="DE" term="%22Pregnant+women%22">Pregnant women</searchLink><br /><searchLink fieldCode="DE" term="%22Movement+disorders%22">Movement disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Anti-NMDA+receptor+encephalitis%22">Anti-NMDA receptor encephalitis</searchLink>
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  Data: Introduction: Anti-N-methyl-D-aspartate receptor (NMDAr) antibody encephalitis is an autoimmune disorder characterized by synaptic NMDAr current disruption and receptor hypofunction, often affecting women during pregnancy. Clinical manifestations associated with anti-NMDAr encephalitis can occur both in the mother and fetus. Methods: We generated a systematic search of the literature to identify epidemiological, clinical, and serological data related to pregnant women with anti-NMDAr encephalitis and their children, analyzing the fetal outcomes. We examined the age and neurologic symptoms of the mothers, the presence of an underlying tumor, immunotherapies used during pregnancy, duration of the pregnancy, and type of delivery. Results: Data from 41 patients were extrapolated from the included studies. Spontaneous interruption of pregnancy, premature birth, and cesarean section were reported in pregnant women with NMDAr encephalitis. Several fetal and neonatal symptoms (e.g., movement disorders, spina bifida, poor sucking, respiratory distress, cardiac arrhythmias, infections, icterus, hypoglycemia, and low birth weight) depending on the mother's serum anti-NR1 concentration were also reported. Conclusions: We characterized the outcomes of children born from mothers with anti-NMDAr encephalitis, analyzing the pivotal risk factors related to pregnancy and maternal disorder. Neuropsychiatric involvement seems strictly related to pathogenic NMDAr antibodies detected in maternal and/or neonatal serum. These findings clarify a complex condition to manage, outlining the risks associated with pregnant women with anti-NMDAr encephalitis and also providing a concrete guide for therapeutic strategies to prevent potential harm to the fetus and the child's neurodevelopment. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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