title: The effect of postpartum intravenous immunoglobulins on the relapse rate among patients with multiple sclerosis.
abstract: OBJECTIVE
  To evaluate the effect of intravenous immunoglobulins (IVIGs) on the expected increase in postpartum relapse rate (RR) among patients with multiple sclerosis (MS).
  
  
  METHODS
  In a retrospective study, data were analyzed from patients with relapsing remitting MS who received postpartum IVIG at the Academic MS Center Limburg, Sittard-Geleen, Netherlands, between April 2005 and January 2015. Patients received 10g IVIG (Nanogam) for 3 consecutive days after childbirth, and then once monthly until 5months after delivery. Data were compared with results from the Pregnancy in Multiple Sclerosis (PRIMS) I and II studies, which followed the natural outcomes of patients with MS with no intervention.
  
  
  RESULTS
  Overall, 42 pregnancies were evaluated. The RR in the first 3months after delivery was 0.48±1.31, as compared with 1.2 in the PRIMS studies. The RR also remained low at 3-6, 6-9, and 9-12months after delivery for patients who received IVIG.
  
  
  CONCLUSIONS
  Postpartum administration of IVIG could be beneficial in preventing childbirth-associated relapses among patients with MS. It led to a substantial decrease in RR.
authors.affiliation: Neurology, Maastricht Universitair Medisch Centrum, Maastricht, Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Brandt-Wouters
authors.affiliation: Neurology, Zuyderland Medisch Centrum, Sittard-Geleen, Netherlands. Electronic address: ol.gerlach@orbisconcern.nl.
authors.forename: Oliver H H
authors.initials: OH
authors.lastname: Gerlach
authors.affiliation: Neurology, Zuyderland Medisch Centrum, Sittard-Geleen, Netherlands.
authors.forename: Raymond M M
authors.initials: RM
authors.lastname: Hupperts
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009426:Netherlands; D049590:Postpartum Period; D011247:Pregnancy; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: Childbirth; Intravenous immunoglobulins; Multiple sclerosis; Postpartum relapse; Pregnancy; Relapse rate