2022
Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic
HRADILEK, Pavel, Eva MELUZINOVA, Olga ZAPLETALOVA, Petra HANULIKOVA, Dana HORAKOVA et. al.Základní údaje
Originální název
Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic
Autoři
HRADILEK, Pavel (203 Česká republika, garant), Eva MELUZINOVA (203 Česká republika), Olga ZAPLETALOVA (203 Česká republika), Petra HANULIKOVA (203 Česká republika), Dana HORAKOVA (203 Česká republika), Ivana WOZNICOVA (203 Česká republika), Lubomir PAVLISKA (203 Česká republika), Ivana STETKAROVA (203 Česká republika), Martin VALIS (203 Česká republika), Pavel ŠTOURAČ (203 Česká republika, domácí), Jana ADAMKOVA (203 Česká republika), Radek AMPAPA (203 Česká republika), Marta VACHOVA (203 Česká republika) a Jan MARES (203 Česká republika)
Vydání
MULTIPLE SCLEROSIS AND RELATED DISORDERS, OXFORD, ELSEVIER SCI LTD, 2022, 2211-0348
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30210 Clinical neurology
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 4.000
Kód RIV
RIV/00216224:14110/22:00128222
Organizační jednotka
Lékařská fakulta
UT WoS
000791995000014
Klíčová slova anglicky
Multiple sclerosis; Pregnancy; EDSS; Relapses; Czech national registry ReMuS
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 23. 1. 2023 12:59, Mgr. Tereza Miškechová
Anotace
V originále
Background: A special care of MS women planning a pregnancy is highly demanding especially in the terms of disease modifying treatment (DMD) decisions and counselling regarding periods of conception, pregnancy and postpartum period.Objective: To provide data about impact of pregnancy, delivery or miscarriage/artificial abortion on MS disease course in Czech women with MS based on analysis of retrospective data from the Czech national registry ReMuS.Methods: The analysis focused on women with MS with at least one record of pregnancy in the registry. Clinical data (EDSS, relapses) were collected prior to conception, during pregnancy and after delivery or miscarriage/ artificial abortion. These data were analysed according to baseline characteristics of DMD treatment prior to conception and according to breastfeeding status.Results: A total of 1 533 pregnancies were analysed from the period of 2013 until 31st December 2019. The occurrence of relapses and worse EDSS was significantly related to the treatment with escalation therapy prior to conception. Relapses were significantly more frequent in women who breastfed less than 3 months than in women who breastfed more than 3 months or did not breastfeed at all. Patients treated with either fingolimod or natalizumab prior to pregnancy were significantly more likely to develop relapses during pregnancy.Conclusion: Pregnancy and postpartum period were generally safe for Czech women with MS. Better disease outcomes were observed in those who had been treated with first line injectable DMDs prior to conception and those who either breastfed more than 3 months or did not breastfeed at all. We confirmed the assumption of rebound phenomenon of MS after discontinuation of treatment due to planned pregnancy both for fingolimod and natalizumab.