怀孕期间和分娩后一年的复发活动与多发性硬化症中残疾进展的加速有关
Lea I Walter1, Veronika Kana1, Sarah Hösli1
1Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Multiple sclerosis and related disorders
|December 19, 2025
概括
在怀孕期间治疗多发性硬化症 (MS) 需要仔细选择疾病修饰疗法 (DMT). 较低的DMT使用与更高的复发率相关,特别是产后,而继续使用纳塔利祖马布可能会降低风险.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 生殖医学 生殖医学
背景情况:
- 怀孕期间多发性硬化症 (MS) 管理存在挑战,特别是在疾病修饰疗法 (DMT) 和产后复发风险方面.
- 了解复发和残疾进展的预测因素对于优化MS孕妇护理至关重要.
研究的目的:
- 调查DMT暴露对多发性硬化症妇女怀孕期间和产后一年内复发率和残疾进展的影响.
- 在这个人群中确定复发和长期残疾的临床和放射学预测因素.
主要方法:
- 对66名患有多发性硬化症的妇女96次怀孕 (2010-2023) 的回顾性分析,重点关注DMT暴露,复发发生,残疾进展 (EDSS) 和MRI发现.
- 对纳塔利祖马布使用及其与复发风险相关性的子组分析.
主要成果:
- 较低的DMT暴露与怀孕和产后复发风险更高相关 (66.7%与87.3%相比).
- 复发更常见于分娩后 (60.5%),在第一季度达到顶峰,并与增加残疾进展和MRI病变有关.
- 在第三季度继续使用纳塔利祖马布,治疗患者的复发风险降低.
结论:
- 对于患有多发性硬化症的孕妇来说,DMT管理至关重要,持续使用natalizumab可能有利于高风险怀孕.
- 需要量身定制的治疗策略来缓解产后复发和长期残疾.
- 怀孕结果一般是有利的,对分娩或新生儿健康没有显著影响.
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