Pregnancy and Multiple Sclerosis: An Update on the Disease Modifying Treatment Strategy and a Review of Pregnancy’s Impact on Disease Activity (original) (raw)
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Pregnancy and multiple sclerosis ?a 3-year prospective study
Journal of Neurology, 1994
A prospective study of the level of disability, severity and distribution of relapses in 15 women with multiple sclerosis prior to, during and up to 3 years following pregnancy was undertaken. The pregnant group was compared with 22 nulliparous women attending the same clinic and matched for age and severity and duration of disease. In the pregnant group, relapses were more frequent and severe than expected values during the first 6 months post partum, but were below expected values 6-24 months post partum. Over the total study period, therefore, there were no significant differences in relapse number, Expanded Disability Status Score or functional scores between the two groups. Babies born during the study showed normal distributions of weight and head circumference.
Pregnancy in the context of Multiple Sclerosis
Revista medicală română, 2022
Multiple Sclerosis is a chronic autoimmune neurodegenerative disorder which affects brain, spinal cord and optic nerve. During last years the perception over the disease changed dramatically, now being considered a handleable disease. The particularity of this subject is that Multiple Sclerosis is a disease which affects mostly young women, many of them not having any children at the moment of diagnosis. This article highlights the fact that women diagnosed with Multiple Sclerosis are allowed to get pregnant, and, moreover, they are encouraged to live a normal life. In most cases, disease activity freezes during pregnancy, only a small percentage of women will continue to have clinically and radiologically active disease. For those women, IFN-β and Glatiramer Acetate are the first-choice therapies that should be given. In cases when the disease is not responding to common medication, refractory to treatment forms may be successfully treated with Natalizuab, during the first and the second trimester. Breastfeeding is also encouraged, as it has a protective effect on disease progression. The main purpose of this article is to make a literature review in which to summarize the updates regarding pregnancy and postpartum management, relapses management and, also, the impact of pregnancy on Multiple Sclerosis course. The analysis was limited to articles written in English and published between August 2019-October 2022 on PubMed, NCBI and Medical Journals.
Pregnancy and multiple sclerosis: a longitudinal study of 125 remittent patients
1993
The relationship between pregnancy and multiple sclerosis (MS) was assessed in a clinic-based, prospectively followed, population of 125 patients with a remittent onset of MS who had been followed for a mean (SD) of 10.3 (0.1) years. Thirty three women had a total of 49 pregnancies of which 32 had been full term and 17 terminated. There was a three-fold increase in the relapse rate per year during the first three months following delivery, compared with the baseline period of the same patients [1.62(0.38) vs 0.51(0.08) p = 0.05]. During pregnancy itself, the relapse-rate was not different from baseline. The overall relapse rate of the pregnancy group was lower than that of a control group without pregnancies after MS onset, but similar to that of patients who had children after MS onset, but no pregnancy during follow up. Pregnancy did not lead to increased disability. These results confirm that post partum increase in relapse rate is the main event related to pregnancy in MS and un...
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2017
Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system (CNS), most probably autoimmune in origin, usually occurring in young adults with a female/male prevalence of approximately 3:1. Women with MS in the reproductive age may face challenging issues in reconciling the desire for parenthood with their condition, owing to the possible influence both on the ongoing or planned treatment with the possible consequences on the disease course and on the potential negative effects of treatments on foetal and pregnancy outcomes. At MS diagnosis, timely counselling should promote informed parenthood, while disease evolution should be assessed before making therapeutic decisions. Current guidelines advise the discontinuation of any treatment during pregnancy, with possible exceptions for some treatments in patients with very active disease. Relapses decline during pregnancy but are more frequent during puerperium, when MS therapy should be promptl...
Pregnancy and multiple sclerosis: a 2-year experience
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1999
Objective: To present our experience with management of parturients with multiple sclerosis and to examine the role of intravenous immunoglobulin (IVIg) in the prevention of postpartum exacerbations of the disease. Methods: Fifteen patients with multiple sclerosis with a relapsing-remitting course were followed during pregnancy and 6 months postpartum. To prevent postpartum exacerbations, 14 of the patients had received IVIg after delivery. Results: None of the patients who received postpartum IVIg relapsed during the 6 months after delivery. None of the observed obstetric complications nor the operative deliveries could be related to the coexistence of multiple sclerosis. Conclusion: Postpartum IVIg treatment is beneficial in preventing acute childbirth-associated exacerbations in patients with relapsing-remitting multiple sclerosis. Furthermore, this disease does not seem to increase obstetric complications.
A Case Report : Pregnancy with Multiple Sclerosis
Ibrahim Cardiac Medical Journal, 2020
Multiple sclerosis causes disability in young adults and like most autoimmune diseases, affects women more commonly in their child-bearing years. In general, pregnancy does not appear to affect the long-term clinical course of multiple sclerosis and the disease does not affect the course or outcome of pregnancy. In this reportedcase, a pregnant woman with multiple sclerosis showed relapse of the disease in first half of her pregnancy and disease was well controlled in the second half of her pregnancy and postpartum period after taking appropriate measure. Women who have multiple sclerosis and wish to have a family can usually do so successfully with the assistance of their neurologist and obstetrician. Ibrahim Card Med J 2019; 9 (1&2): 93-95