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. 2019 Feb:28:235-243.
doi: 10.1016/j.msard.2019.01.003. Epub 2019 Jan 3.

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

Ai-Lan Nguyen  1 , Eva Kubala Havrdova  2 , Dana Horakova  2 , Guillermo Izquierdo  3 , Tomas Kalincik  4 , Anneke van der Walt  5 , Murat Terzi  6 , Raed Alroughani  7 , Pierre Duquette  8 , Marc Girard  8 , Alexandre Prat  8 , Cavit Boz  9 , Patrizia Sola  10 , Diana Ferraro  10 , Alessandra Lugaresi  11 , Jeannette Lechner-Scott  12 , Michael Barnett  13 , Francois Grand'Maison  14 , Pierre Grammond  15 , Cristina Ramo-Tello  16 , Recai Turkoglu  17 , Pamela McCombe  18 , Eugenio Pucci  19 , Maria Trojano  20 , Franco Granella  21 , Daniele Spitaleri  22 , Vincent Van Pesch  23 , Aysun Soysal  24 , Celia Oreja-Guevara  25 , Freek Verheul  26 , Steve Vucic  27 , Suzanne Hodgkinson  28 , Mark Slee  29 , Radek Ampapa  30 , Julie Prevost  31 , Jose Luis Sanchez Menoyo  32 , Olga Skibina  33 , Claudio Solaro  34 , Javier Olascoaga  35 , Cameron Shaw  36 , Klaus Gregaard Madsen  37 , Kerisha Naidoo  38 , Robert Hyde  39 , Helmut Butzkueven  5 , Vilija Jokubaitis  40 ; MSBase Study Group
Affiliations

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

Ai-Lan Nguyen et al. Mult Scler Relat Disord. 2019 Feb.

Abstract

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.

Keywords: Incidence; Multiple sclerosis; Outcomes; Pregnancy; Therapy.

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