Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study.

Adolescent Adult Cohort Studies Female Follow-Up Studies Humans Immunologic Factors / therapeutic use Incidence Multiple Sclerosis, Relapsing-Remitting / epidemiology Pregnancy Pregnancy Complications / epidemiology Pregnancy Outcome Registries Retrospective Studies Young Adult

Incidence Multiple sclerosis Outcomes Pregnancy Therapy

Journal

Multiple sclerosis and related disorders

ISSN: 2211-0356

Titre abrégé: Mult Scler Relat Disord

Pays: Netherlands

ID NLM: 101580247

Informations de publication

Date de publication:
Feb 2019

Historique:

received: 11 09 2018

accepted: 01 01 2019

pubmed: 10 1 2019

medline: 14 6 2019

entrez: 10 1 2019

Statut: ppublish

Résumé

Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. We identified all women with RRMS aged 15-45 years in the MSBase Registry between 2005-2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed. Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births. We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.

Sections du résumé

BACKGROUND BACKGROUND

Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing.

OBJECTIVE OBJECTIVE

To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS.

METHODS METHODS

We identified all women with RRMS aged 15-45 years in the MSBase Registry between 2005-2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed.

RESULTS RESULTS

Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p = 0.010); but no differences in spontaneous abortions, term or preterm births.

CONCLUSIONS CONCLUSIONS

We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month.

Identifiants

DOI: 10.1016/j.msard.2019.01.003 PMID: 30623864

pubmed: 30623864

pii: S2211-0348(19)30003-3

doi: 10.1016/j.msard.2019.01.003

pii:

doi:

Substances chimiques

Immunologic Factors 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

235-243