COVID-19 in the pregnant or postpartum MS patient: Symptoms and outcomes

Salter, Amber; Cross, Anne H.; Cutter, Gary; Fox, Robert J.; Li, David K.B.; Bebo, Bruce F.; Halper, June; Kanellis, Pamela; Rammohan, Kottil; Newsome, Scott D.

doi:10.1016/j.msard.2022.104028

Cited by 4 publications

(3 citation statements)

References 10 publications

(13 reference statements)

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“…To explain this difference, as speculated in other studies assessing COVID-19 outcomes in pregnant patients with MS, 9,22 we can hypothesize a role of the more intensive specialized care received by MS pregnant patients, considered and treated as “high-risk” pregnancies. Moreover, our study’s collection of data covered the period 2020–2022, while the majority of the studies on the general population had a collection period in early 2020; 8,21 therefore, in our sample, most recent strategies of prevention and newly available treatments for SARS-CoV-2 infection could explain better fetal outcomes.…”

Section: Discussionmentioning

confidence: 82%

“…Instead, in the general population, the infection appears to be associated with higher risk for severe neonatal mortality and morbidity, [17][18][19][20][21] including respiratory distress (OR = 1.66), low birth weight (OR = 1.69), stillbirth (OR = 1.46), and NICU admission (OR = 2.12). 8 To explain this difference, as speculated in other studies assessing COVID-19 outcomes in pregnant patients with MS, 9,22 we can hypothesize a role of the more intensive specialized care received by MS pregnant patients, considered and treated as "high-risk" pregnancies. Moreover, our study's collection of data covered the period 2020-2022, while the majority of the studies on the general population had a collection period in early 2020; 8,21 therefore, in our sample, most recent strategies of prevention and newly available treatments for SARS-CoV-2 infection could explain better fetal outcomes.…”

Section: Discussionmentioning

confidence: 90%

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Impact of COVID-19 on pregnancy and fetal outcomes in women with multiple sclerosis

Aprea,

Schiavetti,

Portaccio

et al. 2024

Mult Scler

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Background: In the general population, maternal COVID-19 is associated with worse maternal and fetal outcomes. Two previous studies have assessed COVID-19 clinical outcomes in pregnant women with multiple sclerosis (MS), but there are no data about maternal and fetal outcomes. Objectives: In this multicenter study, we aimed to assess maternal and fetal outcomes in pregnant women with MS and COVID-19 infection. Methods: We recruited pregnant patients with MS who contracted COVID-19 and were followed up in Italian and Turkish Centers, during 2020–2022. A control group was extracted from a previous Italian cohort. Associations between group (COVID-19 or healthy patients) and clinical outcomes (maternal complications, fetal malformations, and spontaneous abortion) were investigated with a weighted logistic regression where propensity score–based inverse probability of treatment weighting (IPTW) approach was applied for adjusting for difference in baseline confounders. Results: In the multivariable analysis, COVID-19 during pregnancy was associated with a higher risk of maternal complications (odd ratio (OR) = 2.12; 95% confidence interval (CI) = 1.32–3.48; p = 0.002), while it was not associated with higher risk of spontaneous abortion and fetal malformations. Conclusion: Our data indicate that COVID-19 during pregnancy increases the risk of maternal complications, while it seems to have no significant impact on fetal outcomes.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 90%

Impact of COVID-19 on pregnancy and fetal outcomes in women with multiple sclerosis

Aprea,

Schiavetti,

Portaccio

et al. 2024

Mult Scler

View full text Add to dashboard Cite

show abstract

“…Moreover, in a US study pregnancy rates in MS women appeared to be on the rise between 2006 and 2015 against the opposite trend in the general population 9 and an increasing number of pregnancies are being conceived while on treatment with DMDs. 10 While over the past decade several MS studies have addressed the safety of DMDs in pregnancy and lactation, 11 only one small study so far has evaluated COVID-19 clinical outcomes in pregnant and postpartum women with MS. 12 Importantly, management of pregnant women with MS requires further considerations because of (1) the unique immunological environment during pregnancy and postpartum, (2) immunomodulatory therapy use and (3) disease activity. 13 Moreover, in the MS population, recent data suggested that exposure to anti-CD20 agents (such as ocrelizumab or rituximab) and recent use (<1 month) of methylprednisolone may increase the risk of severe COVID-19.…”

Section: Sars-cov2 Infection In Pregnant Women With Multiple Sclerosismentioning

confidence: 99%

Sars-CoV2 infection in pregnant women with multiple sclerosis

Aprea,

Schiavetti,

Portaccio

et al. 2023

Mult Scler

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Background: In the general population, maternal SARS-CoV-2 infection during pregnancy is associated with worse maternal outcomes; however, only one study so far has evaluated COVID-19 clinical outcomes in pregnant and postpartum women with multiple sclerosis, showing no higher risk for poor COVID-19 outcomes in these patients. Objective: In this multicenter study, we aimed to evaluate COVID-19 clinical outcomes in pregnant patients with multiple sclerosis. Methods: We recruited 85 pregnant patients with multiple sclerosis who contracted COVID-19 after conception and were prospectively followed-up in Italian and Turkish Centers, in the period 2020-2022. A control group of 1354 women was extracted from the database of the Multiple Sclerosis and COVID-19 (MuSC-19). Univariate and subsequent logistic regression models were fitted to search for risk factors associated with severe COVID-19 course (at least one outcome among hospitalization, intensive care unit [ICU] admission and death). Results: In the multivariable analysis, independent predictors of severe COVID-19 were age, body mass index ⩾ 30, treatment with anti-CD20 and recent use of methylprednisolone. Vaccination before infection was a protective factor. Vaccination before infection was a protective factor. Pregnancy was not a risk nor a protective factor for severe COVID-19 course. Conclusion: Our data show no significant increase of severe COVID-19 outcomes in patients with multiple sclerosis who contracted the infection during pregnancy.

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