ArticleMultiple sclerosis (Houndmills, Basingstoke, England)2020
Pregnancy and multiple sclerosis in the DMT era: A cohort study in Western Austria.
Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 58 citations in OpenAlex.
- Pediatric-Onset Multiple Sclerosis in Tyrol, Austria: Epidemiology, Clinical Profile and Treatment Patterns from a Single Center (2015-2024).Children (Basel, Switzerland) · 2025Article
- Pregnancy-Related Disease Outcomes in Women With Moderate to Severe Multiple Sclerosis Disability.JAMA network open · 2025Article
- De-escalating and discontinuing disease-modifying therapies in multiple sclerosis.Brain : a journal of neurology · 2025Review
- Reduced childbirth rates in multiple sclerosis from the prodromal phase: Evidence from a population-based cohort study.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Patient-centered pregnancy planning in multiple sclerosis: evidence for a new era.Arquivos de neuro-psiquiatria · 2024Review
- Disease activity and neonatal outcomes after exposure to natalizumab throughout pregnancy.Journal of neurology, neurosurgery, and psychiatry · 2024Observational
- Disparities by Race in Pregnancy Care and Clinical Outcomes in Women With Multiple Sclerosis: A Diverse Multicenter CohortNeurology · 2024Article
- Early postpartum treatment strategies and early postpartum relapses in women with active multiple sclerosis.Journal of neurology, neurosurgery, and psychiatry · 2024Article
- Multiple Sclerosis Disease Activity and Disability Following Cessation of Fingolimod for Pregnancy.Neurology(R) neuroimmunology & neuroinflammation · 2023Article
- Optimizing the "Time to pregnancy" in women with multiple sclerosis: the OPTIMUS Delphi survey.Frontiers in neurology · 2023Article
- Abuse and revictimization in adulthood in multiple sclerosis: a cross-sectional study during pregnancy.Journal of neurology · 2022Article
- Review
- Effect of Rituximab Compared with Natalizumab and Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis: A Cohort Study.Journal of clinical medicine · 2022Article
- Hormone therapy and disease activity in Danish women with multiple sclerosis: A population-based cohort study.European journal of neurology · 2022Article
- Monoclonal Antibodies in the Treatment of Relapsing Multiple Sclerosis: an Overview with Emphasis on Pregnancy, Vaccination, and Risk Management.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Review
- Multiple Sclerosis Disease Activity and Disability Following Discontinuation of Natalizumab for Pregnancy.JAMA network open · 2022Article
- Updated Perspectives on the Challenges of Managing Multiple Sclerosis During Pregnancy.Degenerative neurological and neuromuscular disease · 2022Review
- Multiple sclerosis and COVID-19: How many are at risk?European journal of neurology · 2021Article
- Natalizumab, Fingolimod and Dimethyl Fumarate Use and Pregnancy-Related Relapse and Disability in Women With Multiple Sclerosis.Neurology · 2021Article
- Disease Progression and Obstetric Outcomes of Women with Multiple Sclerosis at a Reference Center in Northeastern Brazil.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2021Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiple sclerosis (MS) predominantly affects women of child-bearing potential. Pregnancy in MS is still a controversial issue lacking standardized treatment recommendations.
objectiveTo examine the reciprocal effects of pregnancy, MS, and disease-modifying treatment (DMT).
methodsWe analyzed 387 pregnancies in 239 women with relapsing remitting multiple sclerosis (RRMS) and ⩾1 pregnancy, establishment of diagnosis >1 year before conception, and ⩾2 years of follow-up after delivery. Relapse rates and Expanded Disability Status Scale (EDSS) scores were compared in the year before conception, during pregnancy, and 2 years postpartum. Binary logistic regression was used to investigate predictors of risk for relapses and disability progression during pregnancy and postpartum.
resultsRisk of relapse and disability progression during pregnancy was predicted by pre-conception relapse activity, higher EDSS score at conception, use of highly effective disease-modifying treatment (H-DMT) pre-conception, and prolonged washout period. Postpartum relapse and disability progression was associated with relapse activity pre-conception and during pregnancy and use of H-DMT pre-conception. Early restart of DMT reduced the risk of postpartum relapse.
conclusionA personalized approach in planning pregnancy in women with MS while on H-DMT needs to be adopted. It seems reasonable maintaining natalizumab closer to conception and restarting the drug early postpartum to reduce the considerable risk of disease reactivation during early pregnancy and after delivery.
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