Pregnancy in the Setting of Multiple Sclerosis.
OBJECTIVE
This article provides a review of the available data on reproductive issues that arise in patients with multiple sclerosis (MS).


RESULTS
Recent findings have replicated earlier findings that pregnancy and possibly breast-feeding bring about a favorable immunomodulatory effect in patients with MS. Use of disease-modifying therapies prior to pregnancy may further decrease a patient's risk for postpartum disease activity.


CONCLUSIONS
The annualized relapse rate in MS decreases during pregnancy, with a nadir in the third trimester, and rebounds significantly in the 3-month postpartum period. Exclusive breast-feeding may exert a beneficial effect in decreasing the postpartum risk for relapse. Certain assisted reproductive technology methods are thought to increase the risk for relapse. Disease-modifying therapies are generally discontinued during pregnancy and lactation with a few exceptions. The pregnancy course is usually routine without significant obstetric complications, and babies, although slightly smaller, are typically healthy.
Michelle
M
Fabian
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016899:Interferon-beta / Q000008:administration & dosage; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D055502:Secondary Prevention / Q000379:methods
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D016899:Interferon-beta