在患有中度至重度多发性硬化症残疾妇女中,与怀孕相关的疾病结果
Jessica Shipley1,2, Heidi N Beadnall3, Paul G Sanfilippo1
1Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
JAMA network open
|September 15, 2025
概括
在患有中度至重度多发性硬化症 (MS) 的妇女中,怀孕并没有加剧长期残疾. 然而,在怀孕期间管理MS复发对于最佳结果至关重要.
科学领域:
- 神经学 神经学
- 生殖医学 生殖医学
- 免疫学 免疫学 免疫学
背景情况:
- 了解怀孕对多发性硬化症 (MS) 的影响对于受影响妇女的计划生育至关重要.
- 患有中度至重度多发性硬化症的妇女需要关于怀孕结果的具体指导.
研究的目的:
- 评估患有中度至重度多发性硬化症的妇女的孕期复发率和残疾进展 (扩展残疾状况量表 (EDSS) 评分≥3).
主要方法:
- 一个多中心的回顾性队列研究分析了MSBase注册表 (1984-2024) 的数据.
- 包括575名患有多发性硬化症的孕妇和1056名匹配的非孕妇对照,所有这些都具有预孕EDSS≥3.
- 对比妊娠周边年复发率 (ARRs) 和时间到6个月的确认残疾恶化 (CDW).
主要成果:
- 怀孕期间复发活动显著下降 (第一季度ARR减少75%),但产后增加.
- 怀孕本身并没有显著改变确认残疾恶化的时间.
- 诸如更高的预先怀孕ARR,某些疾病修饰疗法 (natalizumab,fingolimod),年龄较大以及在怀孕期间继续治疗等因素影响了复发风险.
结论:
- 患有中度至重度多发性硬化症的妇女的怀孕并没有导致更严重的长期残疾.
- 在怀孕期间的复发模式与在不太严重的MS患者中观察到的类似.
- 在妊娠前期优化疾病控制对于管理多发性硬化症至关重要.
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