Thöne Jan, Thiel Sandra, Gold Ralf, Hellwig Kerstin
a Department of Neurology , University Hospital Essen , Essen , Germany.
b Department of Neurology, St. Josef-Hospital , Ruhr-University Bochum , Bochum , Germany.
Expert Opin Drug Saf. 2017 May;16(5):523-534. doi: 10.1080/14740338.2017.1311321. Epub 2017 Apr 17.
Women with multiple sclerosis (MS) are treated early in the disease course with disease modifying therapies (DMT). Updated information is needed on pregnancy outcomes of DMT-exposed pregnancies and the effect of the drug withdrawal on MS disease activity. Areas covered: In this review, we will cover the most important updated management strategies in planning a pregnancy when having MS. Expert opinion: MS itself does not increase the risk of adverse pregnancy outcomes and does not negatively influence the long-term course of the disease. As MS became a treatable disease, management of DMTs before, during and after pregnancy is important. This requires updated knowledge on safety of DMTs as well as data of the effect on disease activity after drug withdrawal. A special challenge is the handling of women with highly active MS, as pregnancy might not be powerful enough to suppress the risk of rebound relapses. Exclusive breastfeeding is an option for many women who want to do so, but in cases of high disease activity and those women who do not want to breastfeed, early reintroduction of MS therapies should be considered.
患有多发性硬化症（MS）的女性在疾病病程早期会接受疾病修正疗法（DMT）治疗。我们需要有关暴露于DMT的妊娠的妊娠结局以及停药对MS疾病活动影响的最新信息。涵盖领域：在本综述中，我们将涵盖患有MS时计划妊娠的最重要的最新管理策略。专家意见：MS本身不会增加不良妊娠结局的风险，也不会对疾病的长期病程产生负面影响。随着MS成为一种可治疗的疾病，妊娠前、妊娠期间和妊娠后的DMT管理很重要。这需要有关DMT安全性的最新知识以及停药后对疾病活动影响的数据。一个特殊的挑战是对高度活跃的MS女性的处理，因为妊娠可能不足以抑制复发反弹的风险。对于许多想要母乳喂养的女性来说，纯母乳喂养是一种选择，但在疾病活动度高的情况下以及那些不想母乳喂养的女性中，应考虑尽早重新引入MS治疗方法。
