Impact of symptomatic multiple sclerosis therapy on pregnancy outcome.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Multiple Sclerosis Journal Pub Date : 2024-11-06 DOI:10.1177/13524585241293363

Laura Witt, Sabrina Haben, Karen Dost-Kovalsky, Natalia Friedmann, Nadine Bast, Theresa Oganowski, Ralf Gold, Sandra Thiel, Kerstin Hellwig

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Abstract

Background: Information on symptomatic therapy (ST) use in women of childbearing age with multiple sclerosis is sparse, and data on the impact of ST pregnancy exposure on pregnancy outcome are lacking.

Objective: To investigate (1) ST use patterns pre-conception, during pregnancy and postpartum and (2) pregnancy outcomes.

Methods: Pregnancy data from the German Multiple Sclerosis and Pregnancy Registry were analyzed for the ST use from pre-conception to postpartum. Pregnancy outcomes were compared between ST-exposed (n = 282) and matched (disease modifying therapy and age) ST-naive (n = 536) pregnancies.

Results: Of 2,449 pregnancies, 1,053 (43.0%) received ST anytime between pre-conception and postpartum, 282 (11.5%) at pre-conception and during pregnancy. The most commonly used drug classes were antidepressants (24.8%), analgetics (31.0%), and anticonvulsives (8.7%). Exposure to ST during pregnancy did not result in an increased incidence of adverse pregnancy outcomes, major congenital abnormalities, or pregnancy complications.

Conclusion: Nearly 50% of women used ST between pre-conception and postpartum, but only 12% pre-conception and during pregnancy. ST use during pregnancy did not adversely affect pregnancy outcomes in our cohort. More data are needed to analyze the effect of ST on pregnancy and fetal outcomes stratified by drug to improve recommendations for ST use in family planning.

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有症状的多发性硬化症治疗对妊娠结局的影响。

背景：有关多发性硬化症育龄妇女使用对症治疗（ST）的信息很少，也缺乏有关ST妊娠暴露对妊娠结局影响的数据：目的：调查（1）孕前、孕期和产后使用 ST 的模式；（2）妊娠结局：方法：对德国多发性硬化症和妊娠登记处的妊娠数据进行分析，了解从孕前到产后使用 ST 的情况。结果：在 2,449 例妊娠中，2,449 例妊娠的妊娠结局为：（1）妊娠期间：（2）妊娠结局：（3）妊娠期间：（4）妊娠结局：（5）妊娠期间：（6）妊娠结局：在 2,449 名孕妇中，1,053 人（43.0%）在孕前和产后随时接受 ST 治疗，282 人（11.5%）在孕前和孕期接受 ST 治疗。最常用的药物类别是抗抑郁药（24.8%）、镇痛药（31.0%）和抗惊厥药（8.7%）。孕期接触 ST 并未导致不良妊娠结局、重大先天畸形或妊娠并发症的发生率增加：近 50%的妇女在孕前和产后使用 ST，但只有 12%的妇女在孕前和孕期使用 ST。在我们的队列中，怀孕期间使用 ST 不会对妊娠结局产生不良影响。需要更多的数据来分析ST对妊娠和胎儿结局的影响，并根据药物进行分层，以改进在计划生育中使用ST的建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple Sclerosis Journal 医学-临床神经学

CiteScore

10.90

自引率

6.90%

发文量

186

审稿时长

3-8 weeks

期刊介绍： Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system. The journal for your research in the following areas: * __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics * __Epidemology and genetics:__ genetics epigenetics, epidemiology * __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures * __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management Print ISSN: 1352-4585