Multiple sclerosis and pregnancy. Impact of multiple sclerosis disease-modifying therapy on the health of newborns

Abstract

Background. Due to the high prevalence of multiple sclerosis (MS) among women of reproductive age, special attention is paid to the management of pregnancy in them. The problem concerning the health of infants born to mothers with MS receiving disease-modifying therapy has not yet been addressed. It is necessary to identify the timing of cessation of drugs changing the course of MS, as well as to find the possibility of mitigating exacerbations during pregnancy using corticosteroid therapy.Objective: to analyze the effects of causal therapy for MS on the health of newborns.Materials and methods. This study included 154 women with MS residing in Moscow region and receiving disease-modifying therapy. We evaluated the course of pregnancy, delivery, and the condition of infants born to these mothers.Results and conclusions. Our findings are consistent with the earlier published data in the general cohort of pregnant women and allowed us to conclude that the presence of MS and history of immunomodulatory therapy do not significantly affect the outcome of pregnancy. The incidence and severity of disorders in infants born to MS mothers did not significantly differ from those in the general population. Prolongation of therapy with drugs that change the course of MS up to pregnancy is most appropriate, since it stabilizes the condition of women in the perinatal period, without causing significant harm to the health of newborns. Immunosuppressive therapy increases the risk of various disorders in infants (such as multiple malformations, low birth weight, prematurity). If a woman develops an exacerbation of MS during pregnancy, it is possible to prescribe a short course of pulse therapy with methylprednisolone.