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Narcolepsy and pregnancy: a retrospective European evaluation of 249 pregnancies |
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| Authors: | Eszter Maurovich‐Horvat David Kemlink Birgit Högl Birgit Frauscher Laura Ehrmann Peter Geisler Katharina Ettenhuber Geert Mayer Rosa Peraita‐Adrados Elena Calvo Gert Jan Lammers Astrid Van der Heide Luigi Ferini‐Strambi Giuseppe Plazzi Francesca Poli Yves Dauvilliers Poul Jennum Helle Leonthin Johannes Mathis Aleksandra Wierzbicka Francisco J Puertas Pierre A Beitinger Isabelle Arnulf Renata L Riha Maria Tormá?iová Jana Slonková Sona Nev?ímalová Karel ?onka the European Narcolepsy Network |
| Institution: | 1. Department of Neurology and Center of clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic;2. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria;3. Department of Psychiatry and Psychotherapy, University Medical Center, Regensburg, Germany;4. Hephata‐Klinik, Schwalmstadt‐Treysa, Germany;5. Sleep and Epilepsy Unit‐Clinical Neurophysiology Department, Gregorio Mara?ón University Hospital, Madrid, Spain;6. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands;7. Sleep Disorders Center, Università Vita‐Salute San Raffaele, Milan, Italy;8. Department of Neurological Sciences, IRCSS Istituto di Scienze Neurologiche, University of Bologna, Bologna, Italy;9. Reference Center for Narcolepsy, H?pital Gui‐de‐Chauliac, INSERM U1061, Montpellier, France;10. Danish Center for Sleep Medicine, Glostrup Hospital and Center of Healthy Aging, University of Copenhagen, Glostrup, Denmark;11. Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;12. Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland;13. Sleep Disorders Unit, University Hospital La Ribera, Alzira, Spain;14. Max Planck Institute of Psychiatry, Munich, Germany;15. Reference Center for Narcolepsy, Pitié‐Salpêtrière Hospital, Paris, France;16. Sleep and Respiratory Medicine, Royal Infirmary Edinburgh, University of Edinburgh, Edinburgh, UK;17. Department of Neurology, Faculty of Medicine, P.J. ?afárik University, Ko?ice, Slovakia;18. Department of Neurology, Faculty Hospital, Ostrava, Czech Republic;19. Karel ?onka MD, DSc, Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Katerinska 30, Praha 2, Prague, Czech Republic.;20. Tel.: +420 21. 224965550;22. fax: +420 224922678;23. e‐mail: ksonka@lf1.cuni.cz |
| Abstract: | In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self‐administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P < 0.001) and had a higher body mass index (BMI) prior to pregnancy (P < 0.01). Weight gain during pregnancy was higher in narcoleptic patients with cataplexy (P < 0.01). More patients with narcolepsy–cataplexy during pregnancy had impaired glucose metabolism and anaemia. Three patients experienced cataplexy during delivery. The rate of caesarean sections was higher in the narcolepsy–cataplexy group compared to the narcolepsy group (P < 0.05). The mean birth weight and gestational age of neonates were within the normal range and did not differ across groups. Neonatal care was affected adversely by symptoms of narcolepsy in 60.1% of those with narcolepsy during pregnancy. This study reports more obstetric complications in patients with narcolepsy–cataplexy during pregnancy; however, these were not severe. This group also had a higher BMI and higher incidence of impaired glucose metabolism during pregnancy. Caesarian section was conducted more frequently in narcolepsy–cataplexy patients, despite cataplexy being a rare event during delivery. Furthermore, symptoms of narcolepsy may render care of the infant more difficult. |
| Keywords: | cataplexy delivery metabolism newborn pregnancy puerperium |