Pregnancy, delivery, and birth outcome in women with multiple sclerosis

Dahl, Julie; Myhr, Kjell–Morten; Daltveit, AK; Hoff, Jana Midelfart; Gilhus, Nils Erik

doi:10.1212/01.wnl.0000188898.02018.95

Cited by 138 publications

(160 citation statements)

References 11 publications

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“…While some studies have shown a higher rate of assisted vaginal deliveries, for example requiring induction and slower progression of labor, 5 there is evidence to suggest that mothers and newborns do equally well and do not have longer birth hospitalizations that non-MS counterparts, even when accounting for longer disease duration and increased disability. 15 Our study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

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Exploring Patients’ Knowledge and Misconceptions about Multiple Sclerosis and Pregnancy

Wesley¹,

Fabian²,

Krieger³

2016

US Neurology

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Multiple sclerosis (MS) is a lifelong neurologic disease affecting the central nervous system and resulting in demyelination and axonal loss over time. Symptoms are widely variable and often involve motor and sensory impairment, vision loss, gait disturbance, cognitive dysfunction, and fatigue. Furthermore, MS is a disease common to women of childbearing age, with 70% of patients being women and with 90% of patients presenting between the ages of 15 and 50.1 Family planning must be taken into account at time of diagnosis and when discussing which disease modifying agent to employ. Accurate knowledge and understanding of family planning issues is important for best outcomes.The relationship between pregnancy and relapse outcomes is complex and Education about peripartum concerns is also paramount. In a study of 461 women with MS, there was a higher rate of caesarian section; however, these findings represented a concurrently higher rate of planned, rather than emergency, caesarian sections, 5 a finding that might reflect an overly cautious approach. Previous practice advocated for caesarian sections to avoid pelvic floor trauma and thus exacerbation of preexisting urinary frequency and bladder control issues; however, it was shown in a study of 273 women in 2006 that urinary incontinence postpartum was more related to duration and severity of MS and not method of delivery. AbstractMultiple sclerosis (MS) has a high incidence in women of childbearing age. Accurate understanding of family planning matters is crucial for best outcomes. Methods: Thirty-seven women with MS aged 18 to 50 completed an anonymous questionnaire at an MS Center in New York City. There were 22 questions pertaining to four main categories: effect of pregnancy on MS, effect of MS on pregnancy, MS medication safety during pregnancy and breastfeeding, and effect of MS on offspring. Results: Mean age of patients was 36 years (standard deviation [SD] ±5.6); 86% had relapsing-remitting (RRMS). Mean time since diagnosis was 6.7 years (SD±5.2); 30.6% had been pregnant since diagnosis. Average correct score was 32.8% (SD±20.3), and while higher in patients who had been pregnant since diagnosis, 40.5% (SD±24.7) versus 31.3% (SD±17.9), there was no statistically significant difference; p=0.21. Largest knowledge deficit pertained to effect of MS on reproduction: average score 27.7% (SD±10.1). Only 21.0% knew that relapses can be treated with steroids during pregnancy; 50.0% of those with prior pregnancy knew this fact. Thirtyfour percent of patients on disease-modifying therapies (DMTs) reported not consistently using birth control. Conclusions: Our data identified misconceptions on important reproductive topics. It is important that providers educate effectively their patients on matters of reproduction.

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Section: Discussionmentioning

confidence: 99%

“…1,5,12 Use of DMTs then necessitates education about consistent contraception and safety while breastfeeding. For example, while there is no evidence that glatiramer acetate is absorbed into a newborn's gastrointestinal tract to any significant degree, safety has not been established.…”

mentioning

confidence: 99%

Exploring Patients’ Knowledge and Misconceptions about Multiple Sclerosis and Pregnancy

Wesley¹,

Fabian²,

Krieger³

2016

US Neurology

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“…En norsk studie viste at barn av mødre med multippel sklerose gjennomsnittlig hadde drøyt 100 g lavere fødselsvekt enn andre barn, og at kvinnen oftere blir forløst med keisersnitt (31).…”

Section: Fødselunclassified

Familieplanlegging, graviditet og amming ved multippel sklerose

Holmøy

Torkildsen²

2016

Tidsskriftet

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“…Badanie PRIMS (Pregnancy-Related Relapse in Multiple Sclerosis) wykazało, że SM nie ma bezpośredniego wpływu na częstość poronień, ciąż pozamacicznych czy na występowanie wad wrodzonych u płodu [27,28]. Inne badania również nie potwierdziły negatywnego wpływu SM na płodność ani śmiertelność okołoporodową [29][30][31]. Ogólnie, czę-stość rzutów SM zmniejsza się w trakcie ciąży.…”

Section: Aspekty Związane Z Ciążą Menopauzą I Terapią Hormonalnąunclassified

Therapy of female sexual dysfunction in multiple sclerosis

Lew–Starowicz¹,

Rola²

2013

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166 StreszczenieStwardnienie rozsiane (sclerosis multiplex -SM) jest jedną z najbardziej powszechnych chorób neurologicznych. Dotyka dwukrotnie częściej kobiety niż mężczyzn i przyczynia się do występowania dysfunkcji seksualnych o złożonej etiologii, które wywierają negatywny wpływ na jakość życia chorych oraz ich relacje w związkach partnerskich. Problemy seksualne u kobiet z SM pozostają niestety często nierozpoznane i nieleczone. Autorzy przedstawiają aktualny stan wiedzy i proponują algorytm terapeutyczny dostosowany do leczenia dysfunkcji seksualnych u kobiet z SM.Słowa kluczowe: stwardnienie rozsiane, dysfunkcje seksualne kobiet, terapia. SummaryMultiple sclerosis (MS) is one of the most prevalent neurological diseases. It is twice as frequent in women as in men. It contributes to sexual dysfunctions that have complex etiology and negative impact on patients' quality of life as well as their relationships. Unfortunately, sexual concerns in MS women often remain unrecognized and untreated. The authors present the current state of knowledge and propose a therapeutical algorithm for the treatment of MS female sexual dysfunction.

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Pregnancy, delivery, and birth outcome in women with multiple sclerosis

Cited by 138 publications

References 11 publications

Exploring Patients’ Knowledge and Misconceptions about Multiple Sclerosis and Pregnancy

Exploring Patients’ Knowledge and Misconceptions about Multiple Sclerosis and Pregnancy

Familieplanlegging, graviditet og amming ved multippel sklerose

Therapy of female sexual dysfunction in multiple sclerosis

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