HRADILEK, Pavel, Eva MELUZINOVA, Olga ZAPLETALOVA, Petra HANULIKOVA, Dana HORAKOVA, Ivana WOZNICOVA, Lubomir PAVLISKA, Ivana STETKAROVA, Martin VALIS, Pavel ŠTOURAČ, Jana ADAMKOVA, Radek AMPAPA, Marta VACHOVA and Jan MARES. Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic. MULTIPLE SCLEROSIS AND RELATED DISORDERS. OXFORD: ELSEVIER SCI LTD, 2022, vol. 59, March 2022, p. 1-7. ISSN 2211-0348. Available from: https://dx.doi.org/10.1016/j.msard.2021.103391.
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Basic information
Original name Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic
Authors HRADILEK, Pavel (203 Czech Republic, guarantor), Eva MELUZINOVA (203 Czech Republic), Olga ZAPLETALOVA (203 Czech Republic), Petra HANULIKOVA (203 Czech Republic), Dana HORAKOVA (203 Czech Republic), Ivana WOZNICOVA (203 Czech Republic), Lubomir PAVLISKA (203 Czech Republic), Ivana STETKAROVA (203 Czech Republic), Martin VALIS (203 Czech Republic), Pavel ŠTOURAČ (203 Czech Republic, belonging to the institution), Jana ADAMKOVA (203 Czech Republic), Radek AMPAPA (203 Czech Republic), Marta VACHOVA (203 Czech Republic) and Jan MARES (203 Czech Republic).
Edition MULTIPLE SCLEROSIS AND RELATED DISORDERS, OXFORD, ELSEVIER SCI LTD, 2022, 2211-0348.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30210 Clinical neurology
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.000
RIV identification code RIV/00216224:14110/22:00128222
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.msard.2021.103391
UT WoS 000791995000014
Keywords in English Multiple sclerosis; Pregnancy; EDSS; Relapses; Czech national registry ReMuS
Tags 14110221, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 23/1/2023 12:59.
Abstract
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.
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