Mental health among children of mothers with multiple sclerosis: A Danish cohort and register‐based study

Andersen, Johanna Balslev; Moberg, Julie Yoon; Niclasen, Janni; Laursen, Bjarne; Magyari, Melinda

doi:10.1002/brb3.1098

Cited by 11 publications

(19 citation statements)

References 25 publications

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“…Overall, the pool of selected articles involved: 1773 individuals with MS (1464 women; 309 males; mean age of 45.04 yrs) and 1758 offspring (845 females; 785 males; 128 of non-specified gender; mean age of 11.02 yrs). Four of these studies were conducted in Europe (Greece, Italy, Denmark and UK) [ 47 , 48 , 49 , 50 ], whilst the others were carried out in Canada and in the USA [ 51 , 52 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among the seven studies selected, six did not report an association between maternal MS and the risk of NDDs in offspring [ 47 , 48 , 50 , 51 , 52 , 53 ] ( Table 3 ). Regarding the possible association between pharmacological treatment for MS during pregnancy and NDDs in children, only one of the selected studies specifically investigated this issue, reporting a significant association [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

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Maternal Multiple Sclerosis and Offspring’s Cognitive and Behavioral Development: What Do We Know until Now?

et al. 2022

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Multiple Sclerosis (MS) is a chronic pathological condition representing one of the main causes of neurological disability in the female young population. MS, as an immune disorder, could impact fetus development, and, considering the need for and the possibility of pharmacological treatment during pregnancy, the possible influence of medication on developmental trajectories represents a topic of great interest. We provide an overview of the available literature on the influence of maternal Multiple Sclerosis on offspring cognitive and behavioral development. A study was conducted on Pubmed, Medline and Google Scholar, considering empirical studies and reviews exclusively in the English language. Maternal MS appears not to be associated with emotional and behavioral problems, as evaluated through retrospective studies. However, a specific cognitive and behavioral phenotype, through the administration of standardized instruments, has not been delineated yet. Available studies on the topic are characterized by poor methodology and do not lead to conclusions. This overview highlights implications for further longitudinal studies which should delineate offspring developmental trajectories, taking into consideration maternal confounding factors and the exposure to pharmacological treatment in pregnancy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Maternal Multiple Sclerosis and Offspring’s Cognitive and Behavioral Development: What Do We Know until Now?

et al. 2022

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“…Case control or cohort studies can be performed by either directly enrolling women into the study [5][6][7] (e.g. identifying women already enrolled in a teratology information service [8,9]), or using routine sources of data [10][11][12] or data from specific pregnancy cohorts [13][14][15][16]. These studies often rely on the existence of an initial suspicion about a specific medication or a specific congenital anomaly (CA), which may be raised using spontaneous reporting systems.…”

Section: Euromedicat Databasementioning

confidence: 99%

Signal Detection in EUROmediCAT: Identification and Evaluation of Medication–Congenital Anomaly Associations and Use of VigiBase as a Complementary Source of Reference

et al. 2021

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Introduction Knowledge on the safety of medication use during pregnancy is often sparse. Pregnant women are generally excluded from clinical trials, and there is a dependence on post-marketing surveillance to identify teratogenic medications. Aims This study aimed to identify signals of potentially teratogenic medications using EUROmediCAT registry data on medication exposure in pregnancies with a congenital anomaly, and to investigate the use of VigiBase reports of adverse events of medications in the evaluation of these signals. Methods Signals of medication-congenital anomaly associations were identified in EUROmediCAT (21,636 congenital anomaly cases with 32,619 medication exposures), then investigated in a subset of VigiBase (45,749 cases and 165,121 exposures), by reviewing statistical reporting patterns and VigiBase case reports. Evidence from the literature and quantitative and qualitative aspects of both datasets were considered before recommending signals as warranting further independent investigation. Results EUROmediCAT analysis identified 49 signals of medication-congenital anomaly associations. Incorporating investigation in VigiBase and the literature, these were categorised as follows: four non-specific medications; 11 likely due to maternal disease; 11 well-established teratogens; two reviewed in previous EUROmediCAT studies with limited additional evidence; and 13 with insufficient basis for recommending follow-up. Independent investigations are recommended for eight signals: pregnen (4) derivatives with limb reduction; nitrofuran derivatives with cleft palate and patent ductus arteriosus; salicylic acid and derivatives with atresia or stenosis of other parts of the small intestine and tetralogy of Fallot; carbamazepine with atrioventricular septal defect and severe congenital heart defect; and selective beta-2-adrenoreceptor agonists with posterior urethral valve and/or prune belly. Conclusion EUROmediCAT data should continue to be used for signal detection, accompanied by information from VigiBase and review of the existing literature to prioritise signals for further independent evaluation.

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“…Some studies indicate that women with MS may have higher risk for delivering neonates with lower birth weight compared with healthy women [15][16][17] . Thus far no long-term adverse pediatric outcomes have been reported 18,19 .…”

Section: Fetal Developmentmentioning

confidence: 99%

Pregnancy-related issues in women with multiple sclerosis: an evidence-based review with practical recommendations

Canibaño

Deleu

Mesraoua

et al. 2020

Journal of Drug Assessment

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Objective: To review the current evidence regarding pregnancy-related issues in multiple sclerosis (MS) and to provide recommendations specific for each of them. Research design and methods: A systematic review was performed based on a comprehensive literature search. Results: MS has no effect on fertility, pregnancy or fetal outcomes, and pregnancies do not affect the long-term disease course and accumulation of disability. There is a potential risk for relapse after use of gonadotropin-releasing hormone agonists during assisted reproduction techniques. At short-term, pregnancy leads to a reduction of relapses during the third trimester, followed by an increased risk of relapses during the first three months postpartum. Pregnancies in MS are not per se high risk pregnancies, and MS does not influence the mode of delivery or anesthesia unless in the presence of significant disability. MRI is not contraindicated during pregnancy; however, gadolinium contrast media should be avoided whenever possible. It is safe to use pulse dose methylprednisolone infusions to manage acute disabling relapses during pregnancy and breastfeeding. However, its use during the first trimester of pregnancy is still controversial. Women with MS should be encouraged to breastfeed with a possible favorable effect of exclusive breastfeeding. Disease-modifying drugs can be classified according to their potential for pregnancy-associated risk and impact on fetal outcome. Interferon beta (IFNb) and glatiramer acetate (GA) may be continued until pregnancy is confirmed and, after consideration of the individual risk-benefit if continued, during pregnancy. The benefit of continuing natalizumab during the entire pregnancy may outweigh the risk of recurring disease activity, particularly in women with highly active MS. GA and IFNb are considered safe during breastfeeding. The use of natalizumab during pregnancy or lactation requires monitoring of the newborn. Conclusions: This review provides current evidence and recommendations for counseling and management of women with MS preconception, during pregnancy and postpartum.

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Mental health among children of mothers with multiple sclerosis: A Danish cohort and register‐based study

Cited by 11 publications

References 25 publications

Maternal Multiple Sclerosis and Offspring’s Cognitive and Behavioral Development: What Do We Know until Now?

Maternal Multiple Sclerosis and Offspring’s Cognitive and Behavioral Development: What Do We Know until Now?

Signal Detection in EUROmediCAT: Identification and Evaluation of Medication–Congenital Anomaly Associations and Use of VigiBase as a Complementary Source of Reference

Pregnancy-related issues in women with multiple sclerosis: an evidence-based review with practical recommendations

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