Highlights
- •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.
Abstract
Objectives
To evaluate the effect of intravenous immunoglobulins (IVIG) on prevention of postpartum
relapses in women with relapsing-remitting multiple sclerosis (RRMS).
Methods
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.
Results
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).
Conclusion
This study provides no evidence of benefit for postpartum administration of IVIG in
women with RRMS.
Keywords
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Article info
Publication history
Published online: November 11, 2019
Accepted:
November 10,
2019
Received in revised form:
November 3,
2019
Received:
October 14,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
