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


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.


CONCLUSIONS
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.
Universidade Metropolitana de Santos, SP, Brazil. yara@bsnet.com.br
Yara Dadalti
YD
Fragoso
Mike
M
Boggild
Miguel Angel
MA
Macias-Islas
Adriana
A
Carra
Kirsty Deborah
KD
Schaerer
Adriana
A
Aguayo
Sandra Maria Garcia
SM
de Almeida
Marcos Papais
MP
Alvarenga
Regina Maria Papais
RM
Alvarenga
Soniza Vieira
SV
Alves-Leon
Walter Oleschko
WO
Arruda
Joseph Bruno Bidin
JB
Brooks
Elizabeth Regina
ER
Comini-Frota
Maria Lucia Brito
ML
Ferreira
Alessandro
A
Finkelsztejn
Juliana Marcon Szymanski
JM
Finkelsztejn
Lucas Dias
LD
de Freitas
Andre Serafin
AS
Gallina
Paulo Diniz
PD
da Gama
Sergio
S
Georgetto
Maria Cristina B
MC
Giacomo
Sidney
S
Gomes
Marcus Vinicius Magno
MV
Gonçalves
Anderson Kuntz
AK
Grzesiuk
Damacio Ramon
DR
Kaimen-Maciel
Josiane
J
Lopes
Giselle A
GA
Lourenco
Fabiola Rachid
FR
Malfetano
Nivea Macedo Oliveira
NM
Morales
Rogerio de Rizo
Rde R
Morales
Celso Luis Silva
CL
Oliveira
Patricia
P
Onaha
Cristiane
C
Patroclo
Sonia Beatriz Felix
SB
Ribeiro
Taysa Alexandrino Gonsalves Jube
TA
Ribeiro
Heidi Johanna
HJ
Salminen
Patricia
P
Santoro
Marcos
M
Seefeld
Paula Vallegas
PV
Soares
Adriana
A
Tarulla
Claudia Cristina Ferreira
CC
Vasconcelos
D000328:Adult; D001118:Argentina; D001938:Brazil; D001942:Breast Feeding; D002585:Cesarean Section; D016208:Databases, Factual; D036861:Delivery, Obstetric; D018450:Disease Progression; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000139:chemically induced / Q000453:epidemiology; D007372:Interferons / Q000009:adverse effects; D008297:Male; D008800:Mexico; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy*; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010455:Peptides / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications; D012008:Recurrence; D012189:Retrospective Studies; D006113:United Kingdom
D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D007372:Interferons