The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis

Abstract Background and objective Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs....

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Published in:	Clinical neurology and neurosurgery Vol. 115; no. 2; pp. 154 - 159
Main Authors:	Fragoso, Yara Dadalti, Boggild, Mike, Macias-Islas, Miguel Angel, Carra, Adriana, Schaerer, Kirsty Deborah, Aguayo, Adriana, de Almeida, Sandra Maria Garcia, Alvarenga, Marcos Papais, Alvarenga, Regina Maria Papais, Alves-Leon, Soniza Vieira, Arruda, Walter Oleschko, Brooks, Joseph Bruno Bidin, Comini-Frota, Elizabeth Regina, Ferreira, Maria Lucia Brito, Finkelsztejn, Alessandro, Finkelsztejn, Juliana Marcon Szymanski, de Freitas, Lucas Dias, Gallina, Andre Serafin, da Gama, Paulo Diniz, Georgetto, Sergio, Giacomo, Maria Cristina B, Gomes, Sidney, Gonçalves, Marcus Vinicius Magno, Grzesiuk, Anderson Kuntz, Kaimen-Maciel, Damacio Ramon, Lopes, Josiane, Lourenco, Giselle A, Malfetano, Fabiola Rachid, Morales, Nivea Macedo Oliveira, Morales, Rogerio de Rizo, Oliveira, Celso Luis Silva, Onaha, Patricia, Patroclo, Cristiane, Ribeiro, Sonia Beatriz Felix, Ribeiro, Taysa Alexandrino Gonsalves Jube, Salminen, Heidi Johanna, Santoro, Patricia, Seefeld, Marcos, Soares, Paula Vallegas, Tarulla, Adriana, Vasconcelos, Claudia Cristina Ferreira
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier B.V 01-02-2013 Elsevier Elsevier Limited
Subjects:	Adult Argentina Biological and medical sciences Brazil Breast Feeding Cesarean Section Clinical trials Databases, Factual Delivery, Obstetric Disease Progression Drug therapy Female Glatiramer Acetate Humans Immunologic Factors - adverse effects Immunologic Factors - therapeutic use Infant, Newborn Infant, Newborn, Diseases - chemically induced Infant, Newborn, Diseases - epidemiology Interferon beta Interferons - adverse effects Male Medical sciences Mexico Multiple sclerosis Multiple Sclerosis - complications Multiple Sclerosis - drug therapy Neurology Neurosurgery Obstetric Labor Complications - epidemiology Peptides - adverse effects Pregnancy Pregnancy Complications Recurrence Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases United Kingdom Womens health Pregnancy Glatiramer acetate Multiple sclerosis Interferon beta Nervous system diseases Multiple pregnancy Surgery Central nervous system disease Beta interferon Inflammatory disease
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Summary:	Abstract Background and objective Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course. Patients and methods Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis. Results From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers’ post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment. Conclusion It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0303-8467 1872-6968
DOI:	10.1016/j.clineuro.2012.04.024