Pregnancy and Multiple Sclerosis: An Update on the Disease Modifying Treatment Strategy and a Review of Pregnancy’s Impact on Disease Activity

Varytė, Guoda; Zakarevičienė, Jolita; Ramašauskaitė, Diana; Laužikienė, Dalia; Arlauskienė, Audronė

doi:10.3390/medicina56020049

Cited by 29 publications

(24 citation statements)

References 45 publications

(71 reference statements)

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“…This may reflect the results obtained from the surveyed pwMS, where those in the 26-35 year age group that had children were comparable to census data, whereas there was a larger disparity for the 36-45 year age group. The accumulation of knowledge about pregnancy outcomes in wMS, as summarized by a number of recent evidence-based reviews on the topic (24)(25)(26), may also have impacted the decision making process in recent years.…”

Section: Discussionmentioning

confidence: 99%

Family Planning Decision Making in People With Multiple Sclerosis

Bonavita

Lavorgna

Worton³

et al. 2021

Front. Neurol.

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Introduction: The majority of people diagnosed with MS are of childbearing or child fathering age, therefore family planning is an important issue for both women and men with MS. Fertility and the course of pregnancy are not affected by MS; however, people with MS (pwMS) may have concerns that there will be a greater risk of complications to the mother and/or adverse pregnancy outcomes either due to the disease or to ongoing medication. This survey aimed to understand family planning decision making in pwMS and related unmet educational needs.Methods: A total of 332 pwMS across the USA, UK, France, Germany, Italy, and Spain were recruited from a specialist patient panel agency to participate in a smartphone-enabled standing panel. The 80-question survey focussed on decision making and information sources for pwMS regarding family planning, as well as behavior during and after pregnancy. Male patients with MS did not respond to specific questions on pregnancy. Survey results were directly compared with the 2016 US and 2010 UN census data.Results: pwMS were more likely to have no children than the general population, particularly in the subgroup of patients aged 36–45 years. A total of 56% of pwMS reported that the disease affected, with different degrees of impact, their family planning decision making. Of these, 21% significantly changed their plans for timing of pregnancy and the number of children, and 14% decided against having children. Participants indicated that healthcare professionals were the primary source of information on family planning (81% of responses). The timing of planned pregnancy was not considered when selecting treatment by 78% of participants.Conclusion: MS was found to significantly impact family planning decision making, with pwMS significantly less likely to have children in comparison with the general population.

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Section: Discussionmentioning

confidence: 99%

Family Planning Decision Making in People With Multiple Sclerosis

Bonavita

Lavorgna

Worton³

et al. 2021

Front. Neurol.

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“…Although it is uncommon, in patients with an agressive type of MS, heamathological disorders was detected in 10 of 13 births. All these sideeffects indicate the need of for caution, but in some cases the benefits from treatment may be higher taen potential damage [27,28].Pregnant patients should be treated with natalizumab only by experienced physicians, and due to the mentioned heamtological abnormalities, the presence of a pediatrician may be needed [29] As mentioned, teriflunomide is classified under the letter X, which indicates strong evidence of foetal harm that may be caused by using this drug during pregnancy. Some authors suggest discontinuing the therapy with teriflunomide, as well as dimethyl fumarate and, if necessary, switching to a safer drug should be considered [30].…”

Section: Discussionmentioning

confidence: 99%

Multiple sclerosis and pregnancy- treatment considerations

Kamieniak¹,

Wolanin²,

Jarosz³

et al. 2020

J Pre Clin Clin Res.

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Multiple sclerosis is a chronic inflammatory disease which, due to the destruction of the fibres of the central nervous system in the process of demyelination, leads to numerous neurological symptoms and progressive disability. The disease is autoimmune, which means that myelin is destroyed by the patient's own cells, caused by improper functionong and regulation of the immune system. Multiple sclerosis affects more and more people and is therefore a significant clinical problem which, to a large Entent, affects women, especially in childbearing age This presents a big challenge for carrying out pregnancy while continuing the therapy, ensuring the safety of the foetus and simultaneously achieving the best possible therapeutic effect. The decision whether the therapy should be continued or whether it should be eliminatedis usually made according to assessment of the possible gains and losse. Despite the lack of clear indications, there are many studies proving the relative safety of the use of individual but not all the drugs during pregnancy. Pregnancy, however, has a fairly good impact on the development of multiple sclerosis, and that safety considerations, especially those concerning the growing foetus, force a decision to change or completely suspend the therapy. In-depth research on the already available and emerging therapeutic pathways in multiple sclerosis bring hope for increasingly better results in the future in the treatment of pregnant patients with multiple sclerosis.

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“…Pregnancy may sometimes alleviate the course of the disease and allow the complete discontinuation of therapy, however, discontinuation may sometimes have more serious consequences, and in many cases it is recommended to conduct treatment before, during and after pregnancy, while breastfeeding. [23] [24] [25]. Interferon beta (IFN-β) seems to be a safe drug during pregnancy, which was reflected in the decision of the EMA (European Medicines Agency), which has authorized the use of this medicine before, during and after pregnancy.…”

Section: Pregnancy and Treatment Of Multiple Sclerosismentioning

confidence: 99%

Multiple sclerosis and pregnancy as a significant social problem in modern neurology

Kamieniak

Wolanin

Marzęda

et al. 2022

J Educ Health Sport

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Along with the increasing number of reported cases, multiple sclerosis, one of the main causes of disability among young adults, is nowadays an increasingly common health problem. Considering the fact that it occurs mainly between 20 and 40 years and affects women more often, the question of the impact of the disease on pregnancy becomes obvious. In view of the wide selection of drugs for various purposes and often highly individualized forms of therapy, it seems also important to determine the safety profile of these agents in relation to the health of the pregnant woman and the fetus. All of this is a significant challenge for neurologists and obstetricians and is the subject of many research and studies. The awareness of society, especially women, in the face of the growing problem seems to be equally important. This paper summarizes the current state of knowledge on these issues.

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Pregnancy and Multiple Sclerosis: An Update on the Disease Modifying Treatment Strategy and a Review of Pregnancy’s Impact on Disease Activity

Cited by 29 publications

References 45 publications

Family Planning Decision Making in People With Multiple Sclerosis

Family Planning Decision Making in People With Multiple Sclerosis

Multiple sclerosis and pregnancy- treatment considerations

Multiple sclerosis and pregnancy as a significant social problem in modern neurology

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