Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study
(2019) Multiple Sclerosis and Related Disorders — Vol. 28, p. 235-243 (2019)
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Nguyen, Ai-Lan 
Jokubaitis, Vilija
- Abstract
- (en) BACKGROUND: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. OBJECTIVE: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. 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: 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: 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.
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Citations
Nguyen, A.-L., Havrdova, E. K., Horakova, D., Izquierdo, G., Kalincik, T., van der Walt, A., Terzi, M., Alroughani, R., Duquette, P., Girard, M., Prat, A., Boz, C., Sola, P., Ferraro, D., Lugaresi, A., Lechner-Scott, J., Barnett, M., Grand’Maison, F., Grammond, P., et al. (2019). Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study. Multiple Sclerosis and Related Disorders, 28, 235-243. https://doi.org/10.1016/j.msard.2019.01.003 (Original work published 2019)