The Potential Preventive Effect of Pregnancy and Breastfeeding on Multiple Sclerosis

Alhomoud, Mohsen Ali; Khan, Abdul Sattar; Al-Homoud, Iftetah

doi:10.1159/000514432

Cited by 6 publications

(4 citation statements)

References 99 publications

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“…Considering published evidence, experts agreed that breastfeeding only confers a mild protective effect to disease reactivation during postpartum (88.1% agreement) [ 18 ]. The authors also agreed to avoid breastfeeding in highly active patients (76.1%), but consensus was not reached on mild-active patients (only 66.6% agreed for lactation).…”

Section: Resultsmentioning

confidence: 99%

Family Planning in Fertile-Age Patients With Multiple Sclerosis (MS) (ConPlanEM Study): Delphi Consensus Statements

Oreja-Guevara,

Tintoré,

Meca

et al. 2023

Cureus

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Family planning is essential for establishing Multiple Sclerosis (MS) prognosis, treatment decision, and disease monitoring. We aimed to generate an expert consensus addressing recommendations for family planning in MS patients of childbearing age.Initially, a committee comprising seven neurologists, experts in the MS field, identified the topics to be addressed. Then, the committee elaborated on different evidence-based preliminary statements. Next, using the Delphi methodology, a panel of neurologists manifested their level of agreement on the different statements using a Likert-type scale. Consensus was reached when ⩾70% of respondents expressed an agreement or disagreement using a five-point scale.Consensus was achieved on 47 out of 63 recommendations after three rounds of evaluations. The panel considered it essential to address family planning in all patients of childbearing age. There was also consensus that treatment should not be delayed due to the patient's desire for pregnancy. Additionally, in highly active patients, planning the pregnancy in the medium to long term using depletory drugs such as cladribine or alemtuzumab might represent a useful strategy. However, risks of adverse effects on the fetus due to drug-associated secondary autoimmunity should be addressed when alemtuzumab is considered. Moreover, the maintenance of natalizumab during pregnancy in very active patients reached expert consensus. Also, the panel supported the use of certain disease-modifying treatment (DMT) during lactation in selected cases.Our results identified specific areas of pregnancy planning in MS patients, where different treatment strategies might be considered to facilitate a safe and successful pregnancy while maintaining clinical and radiological stability.

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Section: Resultsmentioning

confidence: 99%

Family Planning in Fertile-Age Patients With Multiple Sclerosis (MS) (ConPlanEM Study): Delphi Consensus Statements

Oreja-Guevara,

Tintoré,

Meca

et al. 2023

Cureus

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“…Додаткову інформацію про використання препаратів розглянуто у таблиці «Використання хворобомодифікувальної терапії під час планування сім'ї» [16,63,[70][71][72][73][74].…”

Section: вагітністьunclassified

Multiply sclerosis and fertility

Kotsiuba,

Chabanova,

Shulga

et al. 2023

RHW

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The article is a review of modern scientific publications, which are devoted to the problems of fertility and disorders of reproductive functions in patients with multiple sclerosis, the direct impact of this disease and disease-modifying therapy on human reproductive health.Multiple sclerosis belongs to autoimmune neurodegenerative diseases, which today remains the leading cause of non-traumatic disability and leads to the formation of permanent physical defects, cognitive disorders and a decrease of the quality of life. Every year an increased number of people are diagnosed with multiple sclerosis, especially among the young persons of reproductive age, because the debut of the disease falls between the ages of 20 and 40 years.This pathology affects both women and men. Moreover, it should be noted that there are twice more women with multiple sclerosis than men, and the reason for this «phenomenon» remains unknown for certain. It is also unclear why the course and manifestations of the disease differ among individuals of different sexes. Multiple sclerosis has a significant impact on all areas of a person’s life, limiting his capabilities.For many years, it was believed that pregnancy is harmful for women with multiple sclerosis, so doctors did not recommend pregnancy due to the fear that patients would not be able to care for their children due to significant worsening of the disease and progression of disability. And that’s why today among patients, both male and female, fears often arise regarding: the effect of this disease and the drugs used in the treatment of multiple sclerosis on fertility; safety and risks during pregnancy and the postpartum period; possibilities and effectiveness of using assisted reproductive technologies as needed.A rather important step for a patient with multiple sclerosis is family planning, which should include counseling on the choice of contraceptive methods, drugs for disease-modifying and symptomatic therapy, a multidisciplinary approach to pregnancy management in such patients in order to optimize treatment and minimize all possible negative effects to ensure the best result

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“…Breastfeeding may slightly reduce this rate. 36 The most important factor affecting relapses during pregnancy is pre-pregnancy disease activity.…”

Section: Pregnancy and Breastfeeding Considerationsmentioning

confidence: 99%

Multiple sclerosis: Diagnosis, disease-modifying therapy and prognosis

Travers¹,

Tsang²,

Barton³

2022

Aust J Gen Pract

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The Potential Preventive Effect of Pregnancy and Breastfeeding on Multiple Sclerosis

Cited by 6 publications

References 99 publications

Family Planning in Fertile-Age Patients With Multiple Sclerosis (MS) (ConPlanEM Study): Delphi Consensus Statements

Family Planning in Fertile-Age Patients With Multiple Sclerosis (MS) (ConPlanEM Study): Delphi Consensus Statements

Multiply sclerosis and fertility

Multiple sclerosis: Diagnosis, disease-modifying therapy and prognosis

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