[Pregnancy and breastfeeding in women with multiple sclerosis].
Schwangerschaft und Stillzeit bei Frauen mit Multipler Sklerose.
Childbearing
Colostrum phase
Immunomodulatory therapy
Relapse therapy
Risk-benefit assessment
Journal
Der Nervenarzt
ISSN: 1433-0407
Titre abrégé: Nervenarzt
Pays: Germany
ID NLM: 0400773
Informations de publication
Date de publication:
23 Feb 2024
23 Feb 2024
Historique:
accepted:
19
01
2024
medline:
23
2
2024
pubmed:
23
2
2024
entrez:
23
2
2024
Statut:
aheadofprint
Résumé
The diagnosis of multiple sclerosis (MS) in women of reproductive age is associated with many uncertainties regarding childbearing and lactation. Pregnancies of MS patients are not usually considered high-risk pregnancies per se. The likelihood of pregnancy complications or adverse pregnancy outcomes is not increased by the disease; however, a careful planning of pregnancy is important in order to choose the treatment option with the greatest benefit for the mother and the least possible risk for the baby. For highly active courses of the disease, anti-CD20 antibodies, cladribine, or continued administration of natalizumab show the best data. Patients with MS can be supported in their desire to breastfeed. If women have had a very active disease course, it is recommended that treatment should be started as soon as possible postpartum. Interferon-beta preparations, glatiramer acetate and ofatumumab are also approved for use during breastfeeding but off-label breastfeeding is also possible with other monoclonal antibodies. Die Diagnose Multiple Sklerose (MS) bei Frauen im reproduktiven Alter ist mit vielen Unsicherheiten in Bezug auf Kinderwunsch und Stillzeit verbunden. Schwangerschaften von MS-Patientinnen sind per se keine Risikoschwangerschaften. Die Wahrscheinlichkeit für Schwangerschaftskomplikationen oder negative Schwangerschaftsausgänge ist durch die Erkrankung nicht erhöht. Dennoch ist eine sorgfältige Planung der Schwangerschaft wichtig, um die Therapieoption mit größtmöglichem Nutzen für die Mutter und geringstmöglichem Risiko für das Kind zu wählen. Bei hochaktiven Verläufen zeigen Anti-CD20-Antikörper, Cladribin oder die Weitergabe von Natalizumab die besten Daten. MS-Patientinnen können in ihrem Stillwunsch unterstützt werden. Bei zuvor hochaktivem Krankheitsverlauf wird empfohlen, die Therapie postpartal schnellstmöglich zu beginnen. Interferon-β-Präparate, Glatirameracetat und Ofatumumab sind auch in der Stillzeit zugelassen, das Stillen off-label unter anderen monoklonalen Antikörpern ist jedoch auch möglich.
Autres résumés
Type: Publisher
(ger)
Die Diagnose Multiple Sklerose (MS) bei Frauen im reproduktiven Alter ist mit vielen Unsicherheiten in Bezug auf Kinderwunsch und Stillzeit verbunden. Schwangerschaften von MS-Patientinnen sind per se keine Risikoschwangerschaften. Die Wahrscheinlichkeit für Schwangerschaftskomplikationen oder negative Schwangerschaftsausgänge ist durch die Erkrankung nicht erhöht. Dennoch ist eine sorgfältige Planung der Schwangerschaft wichtig, um die Therapieoption mit größtmöglichem Nutzen für die Mutter und geringstmöglichem Risiko für das Kind zu wählen. Bei hochaktiven Verläufen zeigen Anti-CD20-Antikörper, Cladribin oder die Weitergabe von Natalizumab die besten Daten. MS-Patientinnen können in ihrem Stillwunsch unterstützt werden. Bei zuvor hochaktivem Krankheitsverlauf wird empfohlen, die Therapie postpartal schnellstmöglich zu beginnen. Interferon-β-Präparate, Glatirameracetat und Ofatumumab sind auch in der Stillzeit zugelassen, das Stillen off-label unter anderen monoklonalen Antikörpern ist jedoch auch möglich.
Identifiants
pubmed: 38393359
doi: 10.1007/s00115-024-01621-9
pii: 10.1007/s00115-024-01621-9
doi:
Types de publication
English Abstract
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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