Highlights
- •We performed a nationwide survey in order to assess the impact of the UK MS pregnancy guidelines and variation in practice across the UK.
- •The survey consisted of 27 questions about MS management and disease modifying treatment (DMT) prescribing prior to and during pregnancy.
- •We were able to obtain responses from a significant number of MS specialists from across the UK.
- •Whilst practice is evolving, significant variation is still seen between neurologists regarding treatment of MS in pregnancy. There is a need to continually update and communicate guidelines, particularly as recommendations change with increasing evidence.
Abstract
Background
The ABN Multiple Sclerosis (MS) pregnancy guidelines set out to combine best current
evidence with expert consensus. They were developed to provide a practical framework
to support neurologists when counselling women with MS regarding pregnancy. A key
objective was to reduce variation in practice and increase clarity for patients in
an area of uncertainty.
Methods
In order to assess the impact of these guidelines on practice, and assess ongoing
areas of need, we conducted an online survey about MS and pregnancy. This survey was
cascaded via email to UK neurologists between December 2019 and January 2020. Individuals
completed this questionnaire anonymously.
Results
The majority of respondents reported changing their prescribing practice with interferon-beta
preparations (IFN-B) and natalizumab. The ABN guidelines were the most commonly cited
reason for change (76%). However, there was considerable variation in advice regarding
the use of both DMTs in pregnancy.
Conclusions
There is substantial variation in advice given to women with MS around pregnancy,
and this is reflected in prescribing practice by UK Neurologists. Awareness of national
guidelines is good, and these have driven change in a majority of MS neurologists.
There remains the need to continually update and communicate these guidelines, particularly
as recommendations evolve with increasing evidence.
Keywords
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References
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Article info
Publication history
Published online: September 24, 2021
Accepted:
September 19,
2021
Received in revised form:
August 24,
2021
Received:
June 25,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
