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Background In animal models, transplacental transfer of NMDAR-IgG has been shown to adversely affect foetal neurodevelopment. However, case reports of pregnancy complicated by NMDAR antibody encephalitis (NMDAR-Ab-E) have been more reassuring. Thus, the exact maternal/foetal effects of NMDAR-Ab-E complicating pregnancy remain unknown.Methods We systematically reviewed published cases of NMDAR-Ab-E with an onset before, during or after pregnancy. These were compared to our own experience as a specialist centre. Full-text preprint available from MEDRXIV/2024/317822.Results We identified 66 pregnancies amongst 61 women, with the majority resulting in livebirth (80%, 53/66) and recovery with minimal or no maternal deficit (72%, 44/61). Seven neonates were compromised at birth, with one neonatal death. Childhood follow-up was available in 60% of cases, however where available showed good outcomes with only one case of global developmental delay. This is in keeping with our own experience, where 75% (3/4) mothers recovered with no deficit and 88% (7/8) of children had normal development. However, overall assessment is limited by lack of follow-up and frequent missing data, for example only 25% of cases included birthweight.Conclusions Whilst current data is reassuring these significant caveats prevent firm conclusions. These could be addressed through the development of an international registry.sophie.binks@ndcn.ox.ac.uk