ReviewTherapeutic advances in neurological disorders2021
A systematic review of relapse rates during pregnancy and postpartum in patients with relapsing multiple sclerosis.
Review in Therapeutic advances in neurological disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Potential Protective Role of Pregnancy and Breastfeeding in Delaying Onset Symptoms Related to Multiple Sclerosis.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Italian Delphi Consensus on Maternity Care in Multiple Sclerosis: Toward an Interdisciplinary Model of Care.European journal of neurology · 2026Article
- [Clinical and obstetric characteristics in women with multiple sclerosis during pregnancy].Revista medica del Instituto Mexicano del Seguro Social · 2026Article
- Maternal Multiple Sclerosis and Offspring's Developmental and Behavioral Profile: A Case-control Study.Current neuropharmacology · 2026Article
- Parkinson's Spectrum Mechanisms in Pregnancy: Exploring Hypothetical Scenarios for MSA in the Era of ART.International journal of molecular sciences · 2025Review
- Cost effectiveness of different treatment strategies with natalizumab for pregnant women with multiple sclerosis.Journal of neurology · 2025Article
- A narrative review on the safety of glatiramer acetate in multiple sclerosis: focus on Europe.Therapeutic advances in chronic disease · 2025Review
- Disease-modifying therapy during pregnancy and postpartum relapse activity in women with multiple sclerosis undergoing assisted reproductive technology treatment: a nationwide cohort study.BMJ neurology open · 2025Article
- Patient-centered pregnancy planning in multiple sclerosis: evidence for a new era.Arquivos de neuro-psiquiatria · 2024Review
- Lifetime exposure to smoking and substance abuse may be associated with late-onset multiple sclerosis: a population-based case-control study.BMC neurology · 2024Article
- Post-Partum Clinical and Patient-Reported Outcome Changes in Mothers with Multiple Sclerosis: Findings from the NAPPREMS Study.Medicina (Kaunas, Lithuania) · 2024Article
- Pregnant Women with Multiple Sclerosis: An Overview of Gene Expression and Molecular Interaction Using Bioinformatics Analysis.International journal of molecular sciences · 2024Review
- Investigation of pregnancy tendency, reproductive characteristics, and disability in women with multiple sclerosis: A secondary data analysis of the national registry in Iran.Current journal of neurology · 2024Article
- Practical Considerations for Managing Pregnancy in Patients With Multiple Sclerosis: Dispelling the Myths.Neurology. Clinical practice · 2024Review
- Disease-Modifying Therapies (DMTs) in Pregnant and Lactating Women with Multiple Sclerosis: Analysis of Real-World Data from EudraVigilance Database.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Treatment with Cladribine Tablets Beyond Year 4: A Position Statement by Southeast European Multiple Sclerosis Centers.Neurology and therapy · 2023Article
- Intravenous immunoglobulin treatment during pregnancy and the post-partum period in women with multiple sclerosis: A prospective analysis.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPregnancy is widely accepted as a period when relapses of multiple sclerosis (MS) are decreased, with an increased risk of relapse in the first months postpartum. This systematic review evaluated relapses during pregnancy and postpartum, according to disease-modifying therapy (DMT) exposure before, during, and after pregnancy, and the influence of DMT on these outcomes.
methodsWe searched Medline and EMBASE to identify relevant publications from November 2009 to 2019 along with references lists of selected articles. Publications were filtered and assessed by two independent reviewers to ensure appropriate data extraction.
resultsOf 469 articles identified, 28 were included for analysis including 4739 pregnancies in 5324 patients. All five studies comparing natalizumab or fingolimod (high-efficacy DMTs) use preconception versus interferon beta, glatiramer acetate, or dimethyl fumarate, or no DMT suggested that there was a greater risk of relapse during pregnancy following withdrawal of the high-efficacy DMTs. Of 10 studies evaluating relapses during pregnancy, five studies found that continuing DMTs into early pregnancy reduced relapses compared to discontinuing treatment. DMT exposure preconception generally had no effect on postpartum relapses versus no DMT; however, natalizumab or fingolimod use preconception was associated with postpartum relapse versus no high-efficacy DMT in one study. DMT exposure during pregnancy was associated with fewer postpartum relapses versus no DMT exposure in four of seven studies, while three found no difference between groups.
conclusionResults of this systematic review concerning women with relapsing MS show a complex and often conflicting picture regarding DMT exposure and relapses during and after pregnancy. Although our data are limited by variability between studies, there is some evidence suggesting the use of natalizumab or fingolimod preconception is associated with increased risk of relapses during pregnancy, highlighting the need for effective disease-management strategies in these especially high-risk patients.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.