Pregnancy before and after NMOSD diagnosis: a retrospective study highlighting the challenges in a referral center in Brazil

Introduction: Addressing pregnancy-related management issues and the use of medications during this period is crucial in routine clinical consultations for women of childbearing age with neuromyelitis optica spectrum disorder (NMOSD). Objective: To evaluate the epidemiological and clinical characteristics of patients with NMOSD who reported pregnancy, as well as pregnancy outcomes and neonatal data. Methods: We included patients seen between January 2024 and July 2025. Data were gathered through medical record reviews and targeted interviews, focusing on pregnancy, postpartum, and childbirth outcomes. Results: Among the patients included, a total of 52 pregnancies were reported, of which 15 occurred after the diagnosis of NMOSD. No statistically significant differences were observed in variables such as maternal age at pregnancy, pregnancy complications, relapses during and after pregnancy, birth weight, or birth length. However, there was a trend towards older maternal age at pregnancy in patients diagnosed with NMOSD. Conclusion: The impact of NMOSD on pregnancy should be carefully considered during family planning. This approach is essential for effective contraception or the planning of a well-supported pregnancy under the guidance of a multidisciplinary team.