The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis

被引：62

作者：

Fragoso, Yara Dadalti ^{[1
]}

Boggild, Mike ^{[2
]}

Angel Macias-Islas, Miguel ^{[3
]}

Carrad, Adriana ^{[4
]}

Schaerer, Kirsty Deborah ^{[5
]}

Aguayo, Adriana ^{[3
]}

Garcia de Almeida, Sandra Maria ^{[6
]}

Alvarenga, Marcos Papais ^{[7
]}

Papais Alvarenga, Regina Maria

Alves-Leon, Soniza Vieira ^{[6
]}

Arruda, Walter Oleschko ^{[8
]}

Bidin Brooks, Joseph Bruno ^{[1
]}

Regina Comini-Frota, Elizabeth ^{[9
]}

Brito Ferreira, Maria Lucia ^{[10
]}

Finkelsztejn, Alessandro ^{[11
]}

Szymanski Finkelsztejn, Juliana Marcon ^{[11
]}

de Freitas, Lucas Dias ^{[10
]}

Gallina, Andre Serafin

da Gama, Paulo Diniz ^{[12
]}

Georgetto, Sergio ^{[13
]}

Giacomo, Maria Cristina B.

Gomes, Sidney ^{[14
,15
]}

Magno Goncalves, Marcus Vinicius ^{[16
]}

Grzesiuk, Anderson Kuntz ^{[17
]}

Kaimen-Maciel, Damacio Ramon ^{[13
]}

Lopes, Josiane ^{[13
]}

Lourenco, Giselle A. ^{[6
]}

Malfetano, Fabiola Rachid ^{[7
]}

Oliveira Morales, Nivea Macedo ^{[18
]}

Morales, Rogerio de Rizo ^{[18
]}

Silva Oliveira, Celso Luis ^{[1
]}

Onaha, Patricia ^{[4
]}

Patroclo, Cristiane ^{[7
]}

Felix Ribeiro, Sonia Beatriz ^{[19
]}

Gonsalves Jube Ribeiro, Taysa Alexandrino ^{[20
]}

Salminen, Heidi Johanna ^{[21
]}

Santoro, Patricia ^{[22
]}

Seefeld, Marcos ^{[23
]}

Soares, Paula Vallegas ^{[1
]}

Tarulla, Adriana ^{[22
]}

Ferreira Vasconcelos, Claudia Cristina ^{[7
]}

机构：

[1] Univ Metropolitana Santos, Santos, SP, Brazil

[2] Walton Ctr, Liverpool L9 7LJ, Merseyside, England

[3] Univ Guadalajara, Guadalajara, Jalisco, Mexico

[4] Hosp Britan Buenos Aires, Buenos Aires, DF, Argentina

[5] Univ Aberdeen, Inst Med Sci, Aberdeen AB25 2ZD, Scotland

[6] Univ Fed Rio de Janeiro, BR-21941 Rio De Janeiro, RJ, Brazil

[7] Univ Fed Estado Rio de Janeiro, Rio De Janeiro, Brazil

[8] Univ Fed Parana, BR-80060000 Curitiba, PR, Brazil

[9] Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil

[10] Hosp Restauracao, Recife, PE, Brazil

[11] Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil

[12] Pontificia Univ Catolica Sao Paulo, Sao Paulo, Brazil

[13] Univ Estadual Londrina, Londrina, PR, Brazil

[14] Hosp Beneficencia Portuguesa, Sao Paulo, Brazil

[15] Hosp Paulistano, Sao Paulo, Brazil

[16] Neurol Clin, Joinville, SC, Brazil

[17] INEC CRIDAC, Hosp Santa Rosa, Cuiaba, MT, Brazil

[18] Univ Fed Uberlandia, Uberlandia, MG, Brazil

[19] Univ Fed Triangulo Mineiro, Uberaba, MG, Brazil

[20] Univ Fed Goias, Goiania, Go, Brazil

[21] Birmingham Childrens Hosp NHS Fdn Trust, Birmingham B4 6NH, W Midlands, England

[22] Inst Invest Med Dr Alfredo Lanari, Buenos Aires, DF, Argentina

[23] Univ Hosp, Fac Evangel Parana, Curitiba, Parana, Brazil

来源：

CLINICAL NEUROLOGY AND NEUROSURGERY | 2013年 / 115卷 / 02期

关键词：

Multiple sclerosis; Pregnancy; Interferon beta; Glatiramer acetate; GLATIRAMER ACETATE; INTERFERON-BETA; OUTCOMES; IMMUNOMODULATORS; NATALIZUMAB; SAFETY; WOMEN;

D O I：

10.1016/j.clineuro.2012.04.024

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and objective: Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course. Patients and methods: Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis. Results: From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers' post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment. Conclusion: It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised. (c) 2012 Elsevier B.V. All rights reserved.

引用

页码：154 / 159

页数：6

共 19 条

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