Multiple sclerosis and pregnancy: experience from a nationwide database in Germany

Area of Science:

• Neurology
• Reproductive Medicine
• Immunology

Background:

• Limited data exist on disease-modifying therapy (DMT) exposure during pregnancy and its effect on multiple sclerosis (MS) relapse rates.
• The impact of exclusive breastfeeding on the postpartum MS disease course remains controversial.

Purpose of the Study:

• To evaluate DMT exposure during pregnancy in 335 MS pregnancies.
• To determine the influence of exclusive breastfeeding on postpartum relapse rates in MS mothers.

Main Methods:

• Data collected from a nationwide MS and pregnancy database.
• Analysis of relapse rates during pregnancy and postpartum periods.
• Comparison of relapse rates between exclusively breastfeeding, non-exclusively breastfeeding, and non-breastfeeding MS mothers.

Main Results:

• Annualized relapse rate decreased during pregnancy in non-exposed mothers.
• No significant increase in congenital anomalies observed in pregnancies exposed to interferon-beta (IFNβ) or glatiramer acetate (GLAT).
• Exclusive breastfeeding (EBF) was associated with a significantly reduced postpartum relapse rate in the first 3 months compared to non-exclusively breastfeeding (NEBF) or non-breastfeeding (NBF) groups.

Conclusions:

• Exclusive breastfeeding demonstrates potential beneficial effects on postpartum relapse rates in MS patients.
• IFNβ and GLAT exposure during pregnancy do not appear to pose a significant teratogenic risk.