- •There was no association between IVIG/no-IVIG and ARR one year after the delivery.
- •We found no predictors of postpartum relapses in women with RRMS.
- •We observed a similar curve of ARR associated with pregnancy as previously reported.
To evaluate the effect of intravenous immunoglobulins (IVIG) on prevention of postpartum relapses in women with relapsing-remitting multiple sclerosis (RRMS).
This was a retrospective study performed in Ljubljana, Slovenia where the practice for all pregnant women with RRMS is to receive IVIG after the delivery (10 g monthly, during first 6 months after delivery) and in Zagreb, Croatia where no such practice exists. The following data were collected: date of delivery, maternal age at delivery, year of the RRMS diagnosis, EDSS, disease modifying therapy prior to pregnancy, relapses in the year prior, during and in the period of one year after pregnancy.
Data on 132 pregnancies from 112 women (mean age at delivery 31.70±4.10, average disease duration 6.34±4.33) were analyzed. There was no association between the IVIG treatment and annualized relapse rate one year after the delivery (0.27 vs 0.38, rate ratio 1.409, 95% CI 0.764–2.598, p = 0.272). No risk factors for the postpartum relapse were identified (age at delivery, duration of RRMS, EDSS prior pregnancy, disease modifying therapy prior pregnancy, relapses in the year prior pregnancy, IVIG).
This study provides no evidence of benefit for postpartum administration of IVIG in women with RRMS.
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- Rate of pregnancy-related relapse in multiple sclerosis. pregnancy in multiple sclerosis group.N. Engl. J. Med. 1998; 339: 285-291
- Predictors and dynamics of postpartum relapses in women with multiple sclerosis.Mult. Scler. 2014; 20: 739-746
- Magnetic resonance imaging of the brain used to detect early post-partum activation of multiple sclerosis.Eur. J. Neurol. 2007; 14: 1216-1221
- Randomised placebo-controlled trial of monthly intravenous immunoglobulin therapy in relapsing-remitting multiple sclerosis. Austrian immunoglobulin in multiple sclerosis study group.Lancet. 1997; 349: 589-593
- Intravenous immunoglobulin G reduces MRI activity in relapsing multiple sclerosis.Neurology. 1998; 50: 1273-1281
- Intravenous immunoglobulin treatment in multiple sclerosis. effect on relapses.Neurology. 1998; 50: 398-402
- Intravenous immunoglobulin treatment in the prevention of childbirth-associated acute exacerbations in multiple sclerosis: a pilot study.J. Neurol. 1996; 243: 25-28
- Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis.J. Neurol. 2004; 251: 1133-1137
- A dose comparison study of ivig in postpartum relapsing-remitting multiple sclerosis.Mult. Scler. 2007; 13: 900-908
- Postpartum treatment with immunoglobulin does not prevent relapses of multiple sclerosis in the mother.Health Care Women Int. 2015; 36: 1072-1080
- The effect of postpartum intravenous immunoglobulins on the relapse rate among patients with multiple sclerosis.Int. J. Gynaecol. Obstet. 2016; 134: 194-196
- Intravenous immunoglobulin treatment in multiple sclerosis: a prospective, rater-blinded analysis of relapse rates during pregnancy and the postnatal period.CNS Neurosci. Ther. 2018; 0: 1-8
- Immunomodulation and postpartum relapses in patients with multiple sclerosis.Ther. Adv. Neurol. Disord. 2009; 2: 7-11
- There is no benefit in the use of postnatal intravenous immunoglobulin for the prevention of relapses of multiple sclerosis: findings from a systematic review and meta-analysis.Arq. Neuropsiquiatr. 2018; 76: 361-366
- Pregnancy-related relapses in a large, contemporary multiple sclerosis cohort: no increased risk in the postpartum period (S6.007).Neurology. 2019; 92: 7
- Low clinical conversion rate in clinically isolated syndrome patients - diagnostic benefit of McDonald 2010 criteria.Eur. J. Neurol. 2017; 0: 1-7
- Relapses and disease-modifying drug treatment in pregnancy and live birth in US women with MS.Neurology. 2018; 91: e1570-e15e8
Published online: November 11, 2019
Accepted: November 10, 2019
Received in revised form: November 3, 2019
Received: October 14, 2019
© 2019 Elsevier B.V. All rights reserved.