Risk factors of pregnancy-related attack using univariate and multivariate logistic regression
| Variable (number of pregnancies) | Univariate analysis | Multivariate analysis | ||
| OR (95% CI) | P value | OR (95% CI) | P value | |
| Age at disease onset (76) | 0.90 (0.83–0.99) | 0.027* | — | 0.799 |
| Age at delivery/abortion | ||||
| 33–40 (12) | 1.00 | 1.00 | ||
| 26.5–33 (39) | 36.67 (4.15–323.86) | 0.001** | 43.61 (4.26–446.91) | 0.001** |
| 20–26.5 (25) | 34.83 (3.70–328.33) | 0.002** | 17.32 (1.64–182.83) | 0.018* |
| Time interval from disease onset to pregnancy (76) | 1.04 (0.90–1.19) | 0.598 | — | — |
| Time interval from last attack to pregnancy (76) | 1.01 (0.99–1.03) | 0.289 | — | — |
| Treatment during pregnancy and after delivery/abortion | ||||
| Adequate treatment† (10) | 1.00 | 1.00 | ||
| Inadequate treatment‡ (66) | 10.67 (2.07–55.07) | 0.005** | 18.45 (2.60–131.19) | 0.004** |
| AQP4-ab titre | ||||
| <1:100 or negative (45) | 1.00 | 1.00 | ||
| ≥1:100 (31) | 4.55 (1.48–13.97) | 0.008** | 4.20 (1.01–17.50) | 0.049* |
| Relapse within 1 year before pregnancy | ||||
| No (58) | 1.00 | |||
| Yes (18) | 0.56 (0.19–1.66) | 0.298 | — | — |
| ARR before pregnancy (76) | 0.57 (0.17–1.95) | 0.373 | — | — |
| EDSS score before pregnancy (76) | 0.96 (0.68–1.34) | 0.808 | — | — |
| Counts of concomitant auto-antibodies§ | ||||
| <1 (42) | 1.00 | |||
| ≥1 (34) | 1.48 (0.56–3.88) | 0.429 | — | — |
| Counts of concomitant auto-antibodies§ | ||||
| <2 (51) | 1.00 | |||
| ≥2 (25) | 1.16 (0.42–3.21) | 0.776 | — | — |
*P< 0.05; **p< 0.01.
†Adequate treatment was defined as (1) usage of relatively higher dose oral prednisone (>10 mg/day), (2) usage of immunosuppressant (azathioprine 100 mg/day or tacrolimus 3 mg/day) combined with or without oral steroid, (3) a dose of rituximab (375 mg/m2) within 6 months before conception and shortly after delivery.
‡Inadequate treatment referred to (1) no treatment at all, (2) usage of low-dose oral prednisone (≤10 mg/day) as single therapy.
§including antinuclear antibody, extractable nuclear antigen antibody, double-stranded DNA antibody, antineutrophil cytoplasmic antibody anticardiolipin antibody, thyroid peroxidase antibody and thyroglobulin antibody.
AQP4-ab, aquaporin-4 antibody; ARR, annualised relapse rate; EDSS, Expanded Disability Status Scale.