Highlights
- •The therapeutic approach for women with Multiple Sclerosis might favor the use of high efficacy drugs before and during pregnancy.
- •High-efficacy therapies are associated with less frequent relapses in the year after pregnancy.
- •The use of high-efficacy treatment during pregnancy is not associated with increased safety concerns for mothers and offspring.
- •Fertility indicators for women with Multiple Sclerosis seem not to be reduced if compared with data recorded in the Italian general population.
Abstract
Background
Pregnancy planning is a relevant issue in the management of Multiple Sclerosis (MS),
which commonly involves women of childbearing age. Increased knowledge and a wider
therapeutic scenario could have changed the approach of neurologists towards this
topic over time. Our aim was to describe how pregnancy planning and management for
women with MS have changed in the last 15 years.
Methods
We retrospectively collected clinical data of female patients with relapsing-remitting
MS (RRMS), referred to the Neurology Clinic of the University-Hospital “Policlinico
G. Rodolico” of Catania, who became pregnant between 2005-2020. We compared data about
MS and pregnancy between two time periods according to pregnancy onset (2005-2012;
2013-2020).
Results
190 patients with RRMS carried 253 pregnancies in the observation period. Women undergoing
a pregnancy in the last period (2013-2020), as compared to women who had pregnancy
in the first period (2005-2012), were older (p<0.01), more often treated before and
during pregnancy with high-efficacy disease-modifying drugs (DMD) (p<0.001), and exhibited
lower annualized relapse rates (ARR) before (p=0.01) and after pregnancy (p<0.001).
Conclusion
Results from our experience suggest that nowadays DMD are more frequently used in
women of childbearing age, even during pregnancy, leading to a reduced ARR before
and after delivery in absence of increased obstetric complications.
Keywords
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Article info
Publication history
Published online: January 19, 2023
Accepted:
January 18,
2023
Received in revised form:
January 10,
2023
Received:
November 22,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
