title: Narcolepsy and pregnancy: a retrospective European evaluation of 249 pregnancies.
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.
authors.affiliation: Department of Neurology and Center of clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
authors.forename: Eszter
authors.initials: E
authors.lastname: Maurovich-Horvat
authors.forename: David
authors.initials: D
authors.lastname: Kemlink
authors.forename: Birgit
authors.initials: B
authors.lastname: Högl
authors.forename: Birgit
authors.initials: B
authors.lastname: Frauscher
authors.forename: Laura
authors.initials: L
authors.lastname: Ehrmann
authors.forename: Peter
authors.initials: P
authors.lastname: Geisler
authors.forename: Katharina
authors.initials: K
authors.lastname: Ettenhuber
authors.forename: Geert
authors.initials: G
authors.lastname: Mayer
authors.forename: Rosa
authors.initials: R
authors.lastname: Peraita-Adrados
authors.forename: Elena
authors.initials: E
authors.lastname: Calvo
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: Lammers
authors.forename: Astrid
authors.initials: A
authors.lastname: Van der Heide
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferini-Strambi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.forename: Helle
authors.initials: H
authors.lastname: Leonthin
authors.forename: Johannes
authors.initials: J
authors.lastname: Mathis
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Wierzbicka
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Puertas
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Beitinger
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
authors.forename: Renata L
authors.initials: RL
authors.lastname: Riha
authors.forename: Maria
authors.initials: M
authors.lastname: Tormášiová
authors.forename: Jana
authors.initials: J
authors.lastname: Slonková
authors.forename: Sona
authors.initials: S
authors.lastname: Nevšímalová
authors.forename: Karel
authors.initials: K
authors.lastname: Sonka
mesh_terms: D000740:Anemia / Q000453:epidemiology; D001724:Birth Weight; D015992:Body Mass Index; D001942:Breast Feeding; D002385:Cataplexy / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D005060:Europe; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D009290:Narcolepsy / Q000453:epidemiology*; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D013997:Time Factors; D015430:Weight Gain
keywords: cataplexy; delivery; metabolism; newborn; pregnancy; puerperium