Gynaecological follow-up for women of reproductive age with multiple sclerosis: The GYNESEP study.

Cervical screening Contraception Counselling Gynaecological follow-up Immunosuppressive therapy Multiple sclerosis

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:
14 Jan 2024
Historique:
received: 14 09 2023
revised: 21 12 2023
accepted: 13 01 2024
medline: 27 1 2024
pubmed: 27 1 2024
entrez: 26 1 2024
Statut: aheadofprint

Résumé

The gynaecological care of women with Multiple Sclerosis has received little attention; most reports focussed on pregnancy or sexuality. The objective of the present study was to evaluate if gynaecological follow-up for women of reproductive age with Multiple Sclerosis was adequate. We performed a cross-sectional study on a large cohort of women with Multiple Sclerosis aged 18-40 years. All participants completed online questionnaires on general health status, gynaecological follow-up, and sexuality. Expanded Disability Status Scale (EDSS) scores were extracted from medical records. The study was registered in clinicaltrials.gov with the number NCT05248438, and in the European database ID-RCB with the number 2021-A02912-39. Of the 192 patients who completed questionnaires, 157 (82.2%) reported gynaecological follow-up. Of the 155 patients on immunosuppressive treatments, only 31 (20%) underwent annual cervical screening. Of the 140 patients who met the French papillomavirus vaccination age recommendations, only 50 (35.7%) were vaccinated. A total of 128 (66.7%) patients used contraception. However, 16 (8.3%) patients reported unplanned pregnancies since the time of diagnosis. Women with Multiple Sclerosis require more information on reproductive health and prevention of cancer. Better contraceptive advice would reduce the number of unplanned pregnancies and avoid foetal exposure to potentially teratogenic treatment.

Sections du résumé

BACKGROUND BACKGROUND
The gynaecological care of women with Multiple Sclerosis has received little attention; most reports focussed on pregnancy or sexuality. The objective of the present study was to evaluate if gynaecological follow-up for women of reproductive age with Multiple Sclerosis was adequate.
METHODS METHODS
We performed a cross-sectional study on a large cohort of women with Multiple Sclerosis aged 18-40 years. All participants completed online questionnaires on general health status, gynaecological follow-up, and sexuality. Expanded Disability Status Scale (EDSS) scores were extracted from medical records. The study was registered in clinicaltrials.gov with the number NCT05248438, and in the European database ID-RCB with the number 2021-A02912-39.
RESULTS RESULTS
Of the 192 patients who completed questionnaires, 157 (82.2%) reported gynaecological follow-up. Of the 155 patients on immunosuppressive treatments, only 31 (20%) underwent annual cervical screening. Of the 140 patients who met the French papillomavirus vaccination age recommendations, only 50 (35.7%) were vaccinated. A total of 128 (66.7%) patients used contraception. However, 16 (8.3%) patients reported unplanned pregnancies since the time of diagnosis.
CONCLUSION CONCLUSIONS
Women with Multiple Sclerosis require more information on reproductive health and prevention of cancer. Better contraceptive advice would reduce the number of unplanned pregnancies and avoid foetal exposure to potentially teratogenic treatment.

Identifiants

pubmed: 38277979
pii: S2211-0348(24)00027-0
doi: 10.1016/j.msard.2024.105448
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT05248438']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105448

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors have nothing to disclose.

Auteurs

Juliette Renaud (J)

Department of Gynecology and Reproductive Medicine, CHU de Bordeaux, Bordeaux F-33000, France.

Pauline Buissonnière (P)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France.

Cécile Dulau (C)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France.

Mathilde Deloire (M)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France.

Florian Hontarrede (F)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France.

Alexis Montcuquet (A)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France.

Lucie Chansel-Debordeaux (L)

Department of Reproductive Biology-CECOS, CHU de Bordeaux, Bordeaux F- 33000, France; Bordeaux Institute of Oncology-BRIC-BioGo Team, INSERM U1312, University of Bordeaux, Bordeaux F-33000, France.

Claude Hocké (C)

Department of Gynecology and Reproductive Medicine, CHU de Bordeaux, Bordeaux F-33000, France.

Jean-Christophe Ouallet (JC)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France.

Aurélie Ruet (A)

Department of Neurology, CHU de Bordeaux, Bordeaux F-33000, France; Neurocentre Magendie, INSERM U1215, University Bordeaux, Bordeaux F-33000, France.

Valérie Bernard (V)

Department of Gynecology and Reproductive Medicine, CHU de Bordeaux, Bordeaux F-33000, France; Bordeaux Institute of Oncology-BRIC-BioGo Team, INSERM U1312, University of Bordeaux, Bordeaux F-33000, France. Electronic address: valerie.bernard@chu-bordeaux.fr.

Classifications MeSH