Neurol. praxi. 2014;15(6):305-309

Woman and multiple sclerosis

doc. MUDr. Jarmila Szilasiová, PhD.
Neurologická klinika LF UPJŠ a UNLP, Košice

The understanding of the effect of pregnancy and hormonal factors provides a new insight into the mechanisms of multiple sclerosis (MS). MS has no negative effect on fertility, course of pregnancy, or fetal health. During pregnancy, the majority of women experience a decrease in disease activity, with a higher risk of relapse in the first three to six months after childbirth. The results of studies on the effect of MS treatment on the course of pregnancy and child development are inconsistent. Pharmacological treatment of MS with a potential teratogenic effect should be discontinued prior to pregnancy. Treatment in the postpartum period depends on disease activity. Assisted reproduction using gonadotropins increases the clinical activity of MS three months after in vitro fertilization. Vitamin D deficiency during pregnancy can be associated with a higher risk of developing MS.

Keywords: multiple sclerosis, pregnancy, treatment

Published: December 20, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Szilasiová J. Woman and multiple sclerosis. Neurol. praxi. 2014;15(6):305-309.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Achiron A, Kishner I, Dolev M, Stern Y, Dulitzki M, Schiff E, Achiron R. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol. 2004; 251: 1133-1137. Go to original source... Go to PubMed...
    2. Amato MP, Portaccio E, Ghezzi A, Hakiki B, Zipoli V, Martinelli V, Moiola L, Patti F, La Mantia L, Mancardi GL, Solaro C, Tola MR, Pozzilli C, De Giglio L, Totaro R, Lugaresi A, Di Tommaso V, Paolicelli D, Marrosu MG, Comi G, Pellegrini F, Trojano M. MS Study Group of the Italian Neurological Society. Pregnancy and fetal outcomes after interferon-? exposure in multiple sclerosis. Neurology. 2010; 75: 1794-1802. Go to original source... Go to PubMed...
    3. Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosi Group. N Engl J Med. 1998; 339: 285-291. Go to original source... Go to PubMed...
    4. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler. 2013; 19: 835-843. Go to original source... Go to PubMed...
    5. Correale J, Farez MF, Ysrraelit MC. Increase in multiple sclerosis activity after assisted reproduction technology. Ann Neurol. 2012; 72: 682-694. Go to original source... Go to PubMed...
    6. De Seze J, Chapelotte M, Delalande S, Ferriby D, Stojkovic T, Vermersch P. Intravenous corticosteroids in the postpartum period for reduction of acute exacerbations in multiple sclerosis. Mult Scler. 2004; 10: 596-597. Go to original source... Go to PubMed...
    7. Ebers GC, Yee IM, Sadovnick AD, Duquette P. Conjugal multiple sclerosis: Population-based prevalence and recurrence risks in offspring. Canadian Collaborative Study Group. Ann Neurol. 2000; 48: 927-931. Go to original source... Go to PubMed...
    8. Gold R, Phillips JT, Havrdova E, Bar-Or A, Kappos L, Yuan H, Novas M, Sweetser M, Viglietta V, Fox R. BG-12 (dimethyl fumarate) and pregnancy: Preclinical and clinical data from the clinical development program. Neurology. 2013; 80(Meeting abstracts 1): P02.129. Go to original source...
    9. Grytten N, Torkildsen O, Aarseth JH, Benjaminsen E, Celius EG, Dahl OP, Holm?y T, L?ken-Amsrud K, Midgard R, Myhr KM, Risberg G, Vatne A, Kampman MT. Month of birth as a latitude-dependent risk factor for multiple sclerosis in Norway. Mult Scler. 2013; 19(8): 1028-1034. Go to original source... Go to PubMed...
    10. Hass J, Hommes OR. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult Scler. 2007; 13(7): 900-908. Go to original source... Go to PubMed...
    11. Havrdová et al. Roztroušená skleróza. Praha, Česká republika: Mladá fronta; 2013: 485.
    12. Hellwig K, Haghikia A, Gold R. Pregnancy and natalizumab: Results of an observational study in 35 accidental pregnancies during natalizumab treatment. Mult Scler. 2011; 17: 958-963. Go to original source... Go to PubMed...
    13. Horáková D. Roztroušená skleróza a mateřství. Neurol. praxi. 2007; 1: 32-34.
    14. Hussain R, Ghoumari AM, Bielecki B, Steibel J, Boehm N, Liere P, Macklin WB, Kumar N, Habert R, Mhaouty-Kodja S, Tronche F, Sitruk-Ware R, Schumacher M, Ghandour MS. The neural androgen receptor: A therapeutic target for myelin repair in chronic demyelination. Brain. 2013; 136: 132-146. Go to original source... Go to PubMed...
    15. Koch M, Uyttenboogaart M, Heersema D, Steen C, De Keyser J. Parity and secondary progression in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2009; 80: 676-678. Go to original source... Go to PubMed...
    16. Langer-Gould A, Huang SM, Gupta R, Leimpeter AD, Greenwood E, Albers KB, Van Den Eeden SK, Nelson LM. Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis. Arch Neurol. 2009; 66: 958-963. Go to original source... Go to PubMed...
    17. Magyari M, Koch-Henriksen N, Pfleger CC, S?rensen PS. Reproduction and the risk of multiple sclerosis. Mult Scler. 2013; 19: 1604-1609. Go to original source... Go to PubMed...
    18. Miller DH, Fazekas F, Montalban X, Reingold SC, Trojano M. Pregnancy, sex and hormonal factors in multiple sclerosis. Mult Scler. 2014; 20(5): 527-536. Go to original source... Go to PubMed...
    19. Mirzaei F, Michels KB, Munger K, O'Reilly E, Chitnis T, Forman MR, Giovannucci E, Rosner B, Ascherio A. Gestational vitamin D and the risk of multiple sclerosis in offspring. Ann Neurol. 2011; 70: 30-40. Go to original source... Go to PubMed...
    20. Nielsen NM, J?rgensen KT, Stenager E, Jensen A, Pedersen BV, Hjalgrim H, Kjaer SK, Frisch M. Reproductive history and risk of multiple sclerosis. Epidemiology. 2011; 22: 546-552. Go to original source... Go to PubMed...
    21. Patas K, Engler JB, Friese MA, Gold SM. Pregnancy and multiple sclerosis: feto-maternal immune cross talk and its implication for disease activity. J Reprod Immunol. 2013; 97(1): 140-146. Go to original source... Go to PubMed...
    22. Portaccio E, Ghezzi A, Hakiki B, Martinelli V, Moiola L, Patti F, La Mantia L, Mancardi GL, Solaro C, Tola MR, Pozzilli C, De Giglio L, Totaro R, Lugaresi A, De Luca G, Paolicelli D, Marrosu MG, Comi G, Trojano M, Amato MP. MS Study Group of the Italian Neurological Society. Breastfeeding is not related to postpartum relapses in multiple sclerosis. Neurology. 2011; 77: 145-150. Go to original source... Go to PubMed...
    23. Pozzilli C, De Giglio V, Barletta F, Marinelli F, De Angelis V, Gallo VA. Efficacy and safety of oral contraceptives as add-on therapy in patients with relapsing-remitting multiple sclerosis receiving subcutaneous interferon b-1a: a multicenter, randomized investigator-run clinical trial. Mult Scler. 2012; 18(Suppl 4): S15. Go to PubMed...
    24. Sandberg-Wollheim M, Frank D, Goodwin TM, Giesser B, Lopez-Bresnahan M, Stam-Moraga M, Chang P, Francis GS. Pregnancy outcomes during treatment with interferon beta-1a in patients with multiple sclerosis. Neurology. 2005; 65: 802-806. Go to original source... Go to PubMed...
    25. Sellner J, Kraus J, Awad A, Milo R, Hemmer B, Stuve O. The increasing incidence and prevalence of female multiple sclerosis - a critical analysis of potential environmental factors. Autoimmun Rev. 2011; 10: 495-502. Go to original source... Go to PubMed...
    26. Spence RD, Voskuhl RR. Neuroprotective effects of estrogens and androgens in CNS inflammation and neurodegeneration. Front Neuroendocrinol. 2012; 33: 105-115. Go to original source... Go to PubMed...
    27. Vukusic S, Hutchinson M, Hours MM, Moreau T, Cortinovis-Tourniare P, Adeleine P, Confravreux C. The Pregnancy in Multiple Sclerosis Group. Pregnancy and multiple sclerosis (the PRIMS study): clinical predictors of post-partum relapse. Brain. 2004: 1353-1360. Go to original source...
    28. Vukusic S, El-Etr M, Ionescu I, Cotton F, Merle H, Cornu C, Frangoulis B, Remontet L, Bossard N, Durelli L, Baulieu EE, Confavreux C. The POPARTMUS French-Italian multicentric trial of Post-Partum Progestin and Estriol in Multiple Sclerosis: Final results. Mult Scler. 2012; 18(S4): 45. Go to PubMed...

    Return to the content


    Neurology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.