Reproductive history of the Danish multiple sclerosis population: A register-based study

Moberg, Julie Yoon; Laursen, Bjarne; Thygesen, Lau Caspar; Magyari, Melinda

doi:10.1177/1352458519851245

Cited by 27 publications

(22 citation statements)

References 36 publications

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“…Shift work at age 15–19 increases the risk of MS in adulthood (Gustavsen et al, 2016). MS seems to considerably impact reproductive choices (Moberg et al, 2019). Immigrants from low‐MS‐risk countries only partially adapted to the risk in Denmark, most pronounced with immigration before age 15 (Nielsen et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

The Danish Multiple Sclerosis Registry

et al. 2020

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Objectives The Danish Multiple Sclerosis Registry is the oldest operative and nationwide MS registry. We present The Danish Multiple Sclerosis Registry with its history, data collection, scientific contribution, and national and international research collaboration. Materials and Methods Detailed description of data collection, completeness, quality optimizing procedures, funding, and legal, ethical and data protection issues are provided. Results The total number of registered cases with clinical isolated syndrome and multiple sclerosis since 1956 was by start of May 2020 30,023 of whom 16,515 cases were alive and residing in Denmark, giving a prevalence rate of about 284 per 100,000 population. The mean annual number of new cases receiving an MS diagnosis was 649 per year in the period 2010 to 2019. In total, 7,945 patients (48.1%) are receiving disease modifying therapy at the start of May 2020. Conclusions Multiple Sclerosis registers are becoming increasingly important, not only for epidemiological research but also by quantifying the burden of the disease for the patients and society and helping health care providers and regulators in their decisions. The Danish Multiple Sclerosis Registry has served as data source for a number of scientific publications including epidemiological studies on changes in incidence and mortality, cohort studies investigating risk factors for developing MS, comorbidities and socioeconomic outcomes in the MS population, and observational studies on effectiveness of disease modifying treatments outside the narrow realms of randomized clinical trials.

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Section: Resultsmentioning

confidence: 99%

The Danish Multiple Sclerosis Registry

et al. 2020

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“…The low number of pregnancies among patients with MS might be explained by the need to postpone pregnancy as a result of the diagnosis of the disease and the prescription of therapies that include medication with potentially adverse pregnancy-related side effects. The burden of functional and cognitive impairment and their impacts on childcare, the fear of pregnancy triggering the progression of the disease, the impact of the disease on gestational risk and the fetus, and the risk of transmitting the disease to offspring have been described by MS patients as factors that discourage reproduction (Roux et al, 2015;Moberg et al, 2020;Ghafoori et al, 2020;Ferraro et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Multiple Sclerosis in Pregnancy and its Role in Female Fertility: A Systematic Review

Lamaita¹,

Melo²,

Laranjeira³

et al. 2021

JBRA

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Multiple sclerosis (MS) is a neurological disease that typically affects young women of reproductive age. There are still many questions and heterogeneous clinical approaches partly due to the lack of consensus and guidelines. For many years, women with MS have been discouraged from getting pregnant for fears that the disease might negatively affect the fetus or increase their obstetric risk or for claims that the disease might decrease fertility. However, fertility does not seem to be impaired to a larger extent in women with MS. Therefore, all healthcare providers involved in the follow-up of multiple sclerosis patients must be prepared to discuss future fertility, pregnancy, and others matters, in addition to providing them with the best possible counseling. This study presents data based on updated evidence and discusses fertility and pregnancy in patients with MS with respect to the impacts of pregnancy on the risk and prognostic factors tied to MS, and the impact of MS on pregnancy outcomes and fertility treatments administered to females with MS. In conclusion, a clear relationship between infertility and MS has not been established. There seems to exist a link between disease aggressiveness and progression with several processes that might impair fertility. However, MS does not stand as a contraindication to assisted reproductive technology. From the several studies analyzed, it is possible to conclude that pregnancy is possible in women with MS. It is important to discuss and plan the ideal moment to start treatment and managing pregnancy and contraception aiming at better results.

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“…In 2017, the total fertility rate in Europe ranged from 1.26 to 1.90 [11]. A nationwide population-based study based on data from The Danish Multiple Sclerosis Registry investigated the total fertility rate among the Danish MS population from 1960 to 2016 and reported a parallel tendency -albeit a consistently lower fertility rate, throughout the entire period for women with MS compared with that of the general population (1.3 vs 1.8 children per woman in 2016) [12]. Conversely, a retrospective study from the U.S. based on administrative claims data reported an increase in the prevalence of pregnancies in women with MS but a decrease in women without MS [13].…”

Section: Fertilitymentioning

confidence: 99%

“…Possible explanations as to why women with MS have fewer children could be that the reproductive decision-making is complicated by having a chronic disease, sexual dysfunction due to MS [18,19], treatment-related temporary amenorrhea [14] or premature ovarian failure [20]. When comparing the whole Danish population of women with MS to the general population from 1960 to 2016 no differences in elective abortions, spontaneous abortions or ectopic pregnancies were reported [12].…”

Section: Fertilitymentioning

confidence: 99%

Pharmacotherapeutic considerations in women with multiple sclerosis

Andersen

Magyari

2020

Expert Opinion on Pharmacotherapy

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Introduction: Multiple sclerosis (MS) is a chronically progressive disease of the central nervous system. The relapsing form of the disease predominantly affects women with onset between the ages 20 to 40 years. Therefore, timing, choice, and treatment options should take pregnancy planning into consideration to accommodate both the needs and safety of the mother and health of the fetus. Areas covered: In this review, the authors discuss and summarize the recent evidence of different pharmacotherapeutic possibilities in the treatment of women with MS. Expert opinion: There is evidence that disease modifying therapy reduces the risk of relapses and diminishes disability progression in people with relapsing MS. The disease is often diagnosed in the childbearing years, and thus pregnancy planning can possibly be a part of the pharmacotherapeutic considerations. The management of women planning pregnancy requires a balancing of risks. The clinician must consider the risks related to treatment discontinuation versus the risk of exposing the developing fetus to drugs that are potential fetotoxic. Randomized controlled trials of medication safety-if used during pregnancy, are prohibited for ethical reasons; hence, the evidence is continuously gathered from observational data, post-authorization studies and pregnancy registries.

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Reproductive history of the Danish multiple sclerosis population: A register-based study

Cited by 27 publications

References 36 publications

The Danish Multiple Sclerosis Registry

The Danish Multiple Sclerosis Registry

Multiple Sclerosis in Pregnancy and its Role in Female Fertility: A Systematic Review

Pharmacotherapeutic considerations in women with multiple sclerosis

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