An Updated Assessment of Patient Knowledge in Pregnancy and Multiple Sclerosis

Abstract.

Multiple sclerosis (MS) is more prevalent in women and is frequently diagnosed during their childbearing years. Prior inquiry into patient knowledge regarding family planning has revealed that patients feel inadequately informed about topics surrounding pregnancy.

We designed and implemented a 13-question survey to assess patient comprehension surrounding pregnancy and treatment options at the Duke Comprehensive MS Center.

Forty-four surveys were returned, with responses from 1 survey not included in the analysis due to most of the questions being left unanswered. The average patient age was 44 years. Thirteen of the 43 participants believed that their risk of relapse would increase during pregnancy, and 4 participants believed that their risk of relapse did not increase after pregnancy. Two patients reported that they had been told they could not have children due to their diagnosis of MS. Twelve of 37 participants reported that they did not have as many children as they would like.

The results of this survey highlight persistent gaps in knowledge regarding the ability to have children, risk of relapse throughout pregnancy and the postpartum period, and treatment options for women of childbearing age with MS. It was also noted that of the 11 participants who indicated that they wanted to have more children in the future, 4 were on disease-modifying therapies that are recommended to be discontinued once pregnant and 1 was on a therapy that is contraindicated in pregnancy. Addressing this gap would require up-to-date and evidence-based discussions about pregnancy in MS beginning at the initial visit and at each subsequent visit to allow individualization of the treatment plan.