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Pregnancy and Multiple Sclerosis: A Narrative Review of Clinical Outcomes, Disease Activity, and Treatment
1Center of Excellence in Pregnancy and Lactation Studies, Thermo Fisher Scientific Inc., London, England, United Kingdom.
Multiple sclerosis (MS) is a chronic autoimmune neurodegenerative disease of the central nervous system, predominantly affecting women during their peak childbearing years. Consequently, concerns about fertility, pregnancy, and parenting are common among patients. Historically, pregnancy was discouraged in women with MS; however, current evidence does not support a significantly increased risk of adverse pregnancy or neonatal outcomes. In fact, MS disease activity typically decreases during pregnancy, particularly in the third trimester, although it often rebounds shortly after delivery. While several disease-modifying drugs (DMDs) are now available, none are specifically approved for use during pregnancy, and safety data in pregnant populations remain limited. For this reason, patients are generally advised to discontinue DMDs upon conception, which may increase the risk of relapse. Encouraging women with MS who become pregnant while on DMD therapy to participate in pregnancy registries could help generate critical safety and outcome data. These data would support more informed clinical decision-making for both patients and healthcare providers regarding MS management during pregnancy.
Multiple sclerosis (MS) is a chronic autoimmune neurodegenerative disease of the central nervous system, predominantly affecting women during their peak childbearing years. Consequently, concerns about fertility, pregnancy, and parenting are common among patients. Historically, pregnancy was discouraged in women with MS; however, current evidence does not support a significantly increased risk of adverse pregnancy or neonatal outcomes. In fact, MS disease activity typically decreases during pregnancy, particularly in the third trimester, although it often rebounds shortly after delivery. While several disease-modifying drugs (DMDs) are now available, none are specifically approved for use during pregnancy, and safety data in pregnant populations remain limited. For this reason, patients are generally advised to discontinue DMDs upon conception, which may increase the risk of relapse. Encouraging women with MS who become pregnant while on DMD therapy to participate in pregnancy registries could help generate critical safety and outcome data. These data would support more informed clinical decision-making for both patients and healthcare providers regarding MS management during pregnancy.
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