Parity is associated with a longer time to reach irreversible disability milestones in women with multiple sclerosis

Masera, Silvia; Cavalla, Paola; Prosperini, Luca; Mattioda, Alessandra; Mancinelli, Chiara; Superti, G; Chiavazza, Carlotta; Vercellino, Marco; Pinessi, Lorenzo; Pozzilli, Carlo

doi:10.1177/1352458514561907

Cited by 46 publications

(41 citation statements)

References 20 publications

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“…Most of the studies have not shown any negative effect of a pregnancy on long-term disease course/progression or disability [32]; some even reported favorable effects [12,29,31]. We showed that MS patients who had only 1 pregnancy had a higher conversion rate from RRMS to SPMS than MS patients with 2 or more pregnancies (p = 0.001).…”

Section: Discussionsupporting

confidence: 53%

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Pregnancy Data in a Turkish Multiple Sclerosis Population

et al. 2015

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Background: To conduct the first retrospective clinical study investigating pregnancy in Turkish multiple sclerosis (MS) patients. Summary: We evaluated 558 pregnancies in 199 MS patients and results were compared with general Turkish population's data. The fertility rate in the MS group was found to be lower than that in the general population, even before MS diagnosis was established. Our study suggests that the higher number of pregnancies may have a favorable effect on transition from relapsing-remitting MS to secondary progressive MS, although no effect has been shown regarding the possibility to reach EDSS 6.0 as a milestone. Key Messages: Our data support the conclusion that MS does not have a negative effect on the MS course and disability.

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Section: Discussionsupporting

confidence: 53%

“…Some data suggested small beneficial effect of pregnancy on long-term MS outcome [4,10,11,12,13]. However, patients with more aggressive disease might choose not to have children and that may cause selection bias in those studies.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Data in a Turkish Multiple Sclerosis Population

et al. 2015

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“…This turned out to be untrue. Some studies suggest pregnancy conveys a long-term benefit [Keyhanian et al 2012;Masera et al 2015;Runmarker and Andersen 1995;Verdru et al 1994], while others find no long-term impact [Karp et al 2014;Ramagopalan et al 2012]. The most accurate current counseling would be to inform patients that pregnancy has no negative effect on long-term prognosis.…”

Section: Pregnancy Impact On Prognosismentioning

confidence: 99%

Management of women with multiple sclerosis through pregnancy and after childbirth

Coyle

2016

Ther Adv Neurol Disord

121

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Multiple sclerosis (MS) is a major acquired neurologic disease of young adults. The prototypic patient is a young woman of reproductive age. Gender preference is becoming more pronounced, since MS is increasing specifically among women. Any healthcare provider who deals with MS must be prepared to discuss pregnancy issues, and provide appropriate counseling. This is now complicated by the availability of multiple treatment options. There is growing literature on which to base recommendations, particularly regarding washout periods. After a brief background introduction, this review will discuss state-of-the-art family planning counseling in the treatment era, divided into prepregnancy, pregnancy, and postpartum MS issues.

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“…The single best predictor for postpartum relapse is the pre‐pregnancy relapse rate . MS relapses occur less often in parous women, and pregnancy after MS onset is associated with a lower risk of progression . A recent systematic review by McKay et al .…”

Section: Effect Of Pregnancy and Breastfeeding On Msmentioning

confidence: 99%

Multiple sclerosis and pregnancy

Kanagaraj

Evangelou

Kapoor

2019

The Obstetric & Gynaecologis

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Multiple sclerosis (MS) is a chronic neurological disease that manifests with clinical and subclinical attacks of central nervous system demyelination. Women are at least twice as likely as men to develop MS, with a mean age of onset of 30 years. Pregnancy has no adverse long-term effect on disease progression, but it is associated with a higher relapse rate in the immediate postpartum period. Pregnancy can worsen pre-existing urinary/bowel dysfunction and motor problems. MS is not associated with significant obstetric or neonatal complications. Learning objectivesTo understand how to manage pregnant women with MS in the multidisciplinary setting.To understand the importance of pre-pregnancy counselling for women with MS who are on disease-modifying drugs. To understand the implications of pregnancy on MS symptoms and their management. To be aware of the benefits of breastfeeding and the safety of disease-modifying drugs and lactation. Ethical issuesIn the absence of clear guidelines, should women ever be advised to avoid pregnancy? Should women be offered in vitro fertilisation treatment, which is known to increase disease relapse?

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Parity is associated with a longer time to reach irreversible disability milestones in women with multiple sclerosis

Cited by 46 publications

References 20 publications

Pregnancy Data in a Turkish Multiple Sclerosis Population

Pregnancy Data in a Turkish Multiple Sclerosis Population

Management of women with multiple sclerosis through pregnancy and after childbirth

Multiple sclerosis and pregnancy

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