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. 2023 Aug:76:104790.
doi: 10.1016/j.msard.2023.104790. Epub 2023 Jun 16.

Is breastfeeding in MS harmful or not? An answer from real-world Czech data

Pavel Hradilek  1 , Olga Zapletalova  2 , Petra Hanulikova  3 , Eva Kubala Havrdova  4 , Ivana Woznicova  5 , Aneta Mazouchova  6 , Jiri Drahota  7 , Michal Lauer  8 , Ivana Stetkarova  9 , Martin Valis  10 , Jana Libertinova  11 , Pavel Stourac  12 , Jana Adamkova  13 , Radek Ampapa  14 , Marta Vachova  15 , Michal Dufek  16 , Alena Martinková  17 , Marek Peterka  18 , Eva Recmanova  19 , Jan Mares  20 , Dana Horakova  4
Affiliations

Is breastfeeding in MS harmful or not? An answer from real-world Czech data

Pavel Hradilek et al. Mult Scler Relat Disord. 2023 Aug.

Abstract

Introduction: The influence of breastfeeding and it´s duration on the course of multiple sclerosis (MS) is unclear. Here we analyzed a real-world data for breastfeeding women with MS and their disease course collected from a Czech national registry ReMuS.

Objectives: To identify risk factors associated with not initiating breastfeeding after delivery, to analyze the impact of breastfeeding on the MS disease course, evaluate the assumption, that breastfeeding is not harmful in MS patients, and compare the disease course by breastfeeding status.

Materials and methods: Using propensity score matching we compared Expanded Disability Status Scale (EDSS), confirmed disease worsening (CDW) and annual relapse rate (ARR) in breastfeeding and non-breastfeeding MS patients according to disease duration, disease modifying treatment (DMT) before pregnancy, last EDSS score before conception, age, and ARR during pregnancy. We also compared these parameters between breastfeeding patients not using a DMT and non-breastfeeding patients who resumed DMT within 3 months after delivery. EDSS, ARR, and CDW were collected at 12, 24, and 36 months after delivery.

Results: A total of 1681 pregnancies that ended in delivery were analyzed from 2013 through 2020. Change in ARR and EDSS values and 6-months CDW did not significantly differ between the analyzed groups. Compared with non-breastfeeding women who resumed DMT early after delivery, breastfeeding women with MS did not experience worse clinical outcomes even without initiating a DMT.

Discussion: Breastfeeding in Czech women with MS did not negatively affect the disease course and can be supported. Patients with MS can be treated with certain DMTs alongside breastfeeding and there is no need to stop breastfeeding, if the patient is clinically stable.

Keywords: Breastfeeding; Czech national multiple sclerosis patient registry ReMuS; EDSS; Multiple sclerosis; Relapses.

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Conflict of interest statement

Declaration of Competing Interest The authors declared potential conflicts of interest with respect to the research, authorship and/or publication of this article as following: P.H. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. O.Z. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. P.H. has nothing to disclose. E.K.H. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. I.W. received compensations for travel from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme and Teva. A.M. has nothing to disclose. J.D. has nothing to disclose. M.L. has nothing to disclose I.S. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. M.V. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. J.L. received compensations for travel and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. P.S. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. J.A. received compensations for travel from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme and Teva. R.A. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. M.V. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. M.D. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. A.M. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. M.P. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. J.M. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag. D.H. received compensations for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck Serono, Roche, Sanofi Genzyme, Teva and Janssen cilag

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