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在接受辅助生殖技术治疗的多发性硬化症妇女怀孕期间和产后复发活动的疾病修饰疗法:全国性的队列研究

Lene von Kappelgaard¹, Elisabeth Framke¹, Ditte Vassard²

¹The Danish Multiple Sclerosis Registry, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.

BMJ neurology open

|July 7, 2025

概括

患有多发性硬化症 (MS) 的女性的产后复发活动在辅助生殖技术 (ART) 产后显著增加,无论怀孕期间是否使用疾病修饰疗法 (DMT). 与怀孕前和怀孕期间相比,产后复发率翻了一番以上.

科学领域:

生殖医学生殖医学
神经学神经学
药理学药理学是指药理学的学科.

背景情况:

关于在怀孕期间使用疾病修饰疗法 (DMT) 对经过辅助生殖技术 (ART) 的多发性硬化症 (MS) 妇女产后复发活动的影响的证据有限.
了解产后复发模式对于通过ART怀孕的妇女管理MS至关重要.

研究的目的:

在怀孕前,怀孕期间,以及分娩后3个月和12个月,调查和比较患有复发性复发性多发性硬化症 (RRMS) 的妇女的复发活动.
在辅助生殖技术 (ART) 后怀孕期间与疾病修饰疗法 (DMT) 暴露有关的复发活动进行分析.

主要方法:

从1995年至2018年间,在ART后分娩的RRMS妇女的回顾性队列研究,从丹麦MS注册表中确定.
每年复发率 (ARR) 用负二项式回归来评估.
后勤回归确定了12个月产后没有复发的预测因素.

主要成果:

总共包括了111名女性,平均年龄为32岁.
总体ARR在怀孕前为0.14,怀孕期间为0.13,并在产后3个月显著增加到0.33 (率比率差异:2.42与怀孕前,2.46与怀孕期间).
在产后12个月没有复发的预测因素包括年龄≥35岁和怀孕前没有DMT暴露.

结论:

与怀孕前和怀孕期间相比,产后期的复发活动增加了一倍以上.
这种产后复发活动的增加不论在怀孕期间接触DMT.
产后复发率显著增加,无论之前的复发活动或DMT暴露状况如何.

关键词:

流行病学流行病学多发性硬化多发性硬化神经免疫学神经免疫学妇产科妇产科妇产科

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