Factors interfering with parenthood decision-making in an Italian sample of people with multiple sclerosis: an exploratory online survey

Lavorgna, Luigi; Esposito, Sabrina; Lanzillo, Roberta; Sparaco, Maddalena; Ippolito, Domenico; Cocco, Eleonora; Fenu, Giuseppe; Borriello, Giovanna; Mercanti, Stefania De; Frau, Jessica; Capuano, Rocco; Trojsi, Francesca; Rosa, Laura; Clerico, Marinella; Laroni, Alice; Morra, Vincenzo Brescia; Tedeschi, Gioacchino

doi:10.1007/s00415-019-09193-4

Cited by 15 publications

(19 citation statements)

References 25 publications

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“…A total of 56% of pwMS reported that the disease affected, with different degrees of impact, their family planning decision making. However, this conflicted with a previous study in Italian pwMS, where only 29% of patients responded that the diagnosis of MS delayed their decision to become a parent ( 22 ). A 2018 study of US pregnancy rates found that there were significantly more pregnant wMS in 2014 than in 2006 ( 23 ).…”

Section: Discussioncontrasting

confidence: 78%

“…HCPs may be able to provide the patients with clearer direct information. The Italian MS patient study found similar results, with 39% of patients counseled by a physician to plan pregnancy (22). A 2018 study on family planning in pwMS from Denmark found that 27% of women and 34% of men received family planning information from an internet source.…”

Section: Discussionmentioning

confidence: 74%

“…Men were found to be less likely to respond that MS made them decide against having children than women; however, this result is not conclusive as there were significantly fewer men in the survey than women. A similar 2019 study in pwMS in Italy found that only 7% of MS patients decided against having children after being diagnosed with diagnosis (22). Cultural differences between countries may account for the varying responses to the impact of MS on family planning, and a further study to evaluate the impact of cultural differences on family planning would be desirable.…”

Section: Discussionmentioning

confidence: 95%

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Family Planning Decision Making in People With Multiple Sclerosis

Bonavita

Lavorgna

Worton³

et al. 2021

Front. Neurol.

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Introduction: The majority of people diagnosed with MS are of childbearing or child fathering age, therefore family planning is an important issue for both women and men with MS. Fertility and the course of pregnancy are not affected by MS; however, people with MS (pwMS) may have concerns that there will be a greater risk of complications to the mother and/or adverse pregnancy outcomes either due to the disease or to ongoing medication. This survey aimed to understand family planning decision making in pwMS and related unmet educational needs.Methods: A total of 332 pwMS across the USA, UK, France, Germany, Italy, and Spain were recruited from a specialist patient panel agency to participate in a smartphone-enabled standing panel. The 80-question survey focussed on decision making and information sources for pwMS regarding family planning, as well as behavior during and after pregnancy. Male patients with MS did not respond to specific questions on pregnancy. Survey results were directly compared with the 2016 US and 2010 UN census data.Results: pwMS were more likely to have no children than the general population, particularly in the subgroup of patients aged 36–45 years. A total of 56% of pwMS reported that the disease affected, with different degrees of impact, their family planning decision making. Of these, 21% significantly changed their plans for timing of pregnancy and the number of children, and 14% decided against having children. Participants indicated that healthcare professionals were the primary source of information on family planning (81% of responses). The timing of planned pregnancy was not considered when selecting treatment by 78% of participants.Conclusion: MS was found to significantly impact family planning decision making, with pwMS significantly less likely to have children in comparison with the general population.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 95%

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Family Planning Decision Making in People With Multiple Sclerosis

Bonavita

Lavorgna

Worton³

et al. 2021

Front. Neurol.

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“…22,23 In a previous Italian study only a minority of patients with MS had received doctor counseling to plan pregnancy or to avoid accidental maternity. 13 In a Swiss MS patients survey, only a few neurologists initiated the subject of pregnancy at each consultation, whereas a greater number did so sporadically, when the patient asked, or did not raise the topic of pregnancy at all. 14 Another study from Germany focused on investigating neurologists' expertise in MS and pregnancy found that respondents answered about half of the questions correctly.…”

Section: Discussionmentioning

confidence: 99%

“…There are several reports in the literature on the use of simple self-report measures or surveys that assess how MS patients plan their pregnancy. [13][14][15] This study highlights that pregnancy remains an important yet unresolved concern in the treatment of MS patients.…”

Section: Introductionmentioning

confidence: 99%

Family planning in Argentinian women with multiple sclerosis: An important yet seldom approached issue

Alonso

Patrucco²,

Silva

et al. 2021

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background The purpose of this study was to assess family planning (FP) among women with multiple sclerosis (WwMS). Methods We invited 604 WwMS to answer a survey focused on FP: a) Temporal relationship between pregnancy and the diagnosis of multiple sclerosis; b) History of FP; c) Childbearing desire; d) Information on family planning. Comparisons between pregnancy and not pregnancy after MS, as well as, planned and unplanned pregnancy were analyzed. Multivariate and univariate analyses were used to assess the impact of independent variables and FP Result 428 (71.7%) WwMS completed the survey. A 19.1% got pregnant after MS diagnosis and we evaluated FP in the last pregnancy, 56.1% patients had a planned pregnancy. Professional addressing FP (OR = 0.27, 95%-CI 0.08-0.92, p = 0.03) and non-injection drug treatment before pregnancy (OR = 2.88, 95%-CI 1.01-8.21, p = 0.047) were independent predictors of unplanned pregnancy in our multivariate model. Among WwMS ≤ 40 years, 48.7% had future childbearing desire. Young age (p < 0.001), PDDS <3 (p = 0.018), disease duration <5 years (p = 0.02), not childbearing before MS diagnosis (p < 0.001) and neurologist addressing family planning (p = 0.01) were significantly associated with childbearing desire. Conclusions This research highlights that pregnancy remains an important concern among WwMS.

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Ovarian reserve in patients with multiple sclerosis: A systematic review and meta‐analysis

Carbone

Girolamo

Conforti

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo summarize recent evidence about ovarian reserve markers in women affected by multiple sclerosis (MS) compared with healthy controls, as women with MS seem to be characterized by lower anti‐Müllerian hormone (AMH) levels.MethodsThe research was conducted using PubMed (MEDLINE), Scopus, ClinicalTrial.gov, OVID and Cochrane Library from inception of each database to June 30, 2022. Studies comparing ovarian reserve markers between women with MS and healthy controls were considered eligible for inclusion. The primary outcome was serum AMH (ng/mL) levels. Results were reported as pooled odds ratio (OR) for categorical outcomes and as mean difference (MD) for continuous variables, with their 95% confidence intervals (CIs). The random effect model of DerSimonian and Laird was adopted for all analyses. A P‐value less than 0.05 was considered significant.ResultsSerum AMH circulating levels were not significantly different (MD −0.25, 95% CI −0.83 to 0.32; P = 0.390), as well as blood levels of follicle‐stimulating hormone or ovarian volume. However, antral follicle count (AFC) and estradiol blood levels were significantly lower, and luteinizing hormone (LH) levels were significantly higher in women with MS than in controls.ConclusionA significant difference in AFC, estradiol and LH levels was observed, but not for AMH levels.

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Factors interfering with parenthood decision-making in an Italian sample of people with multiple sclerosis: an exploratory online survey

Cited by 15 publications

References 25 publications

Family Planning Decision Making in People With Multiple Sclerosis

Family Planning Decision Making in People With Multiple Sclerosis

Family planning in Argentinian women with multiple sclerosis: An important yet seldom approached issue

Ovarian reserve in patients with multiple sclerosis: A systematic review and meta‐analysis

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