Al Jumah Mohammed, Al Malik Yaser, AlKhawajah Nuha M, Saeedi Jameelah, AlThubaiti Ibtisam, Bohlega Saeed, Bunyan Reem F, Cupler Edward J, ElBoghdady Ahmed, Hassan Ahmed, Ali Eman Nassim, Clerico Marinella
Neurology Department, King Fahad Medical City, Riyadh, Saudi Arabia.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Mult Scler Int. 2021 Feb 15;2021:6667006. doi: 10.1155/2021/6667006. eCollection 2021.
More than half of all patients with multiple sclerosis (MS) in the Kingdom of Saudi Arabia (KSA) are women of childbearing age. Raising a family is an important life goal for women in our region of the world. However, fears and misconceptions about the clinical course of relapsing-remitting MS (RRMS) and the effects of disease-modifying drugs (DMDs) on the foetus have led many women to reduce their expectations of raising a family, sometimes even to the point of avoiding pregnancy altogether. The increase in the number of DMDs available to manage RRMS and recent studies on their effects in pregnancy have broadened management options for these women. Interferon beta now has an indication in Europe for use during pregnancy (according to clinical need) and can be used during breastfeeding. Glatiramer acetate is a further possible option for women with lower levels of RRMS disease activity who are, or about to become, pregnant; natalizumab may be used up to 30 weeks in patients with higher levels of disease activity. Where possible, physicians need to support and encourage women to pursue their dream of a fulfilling family life, supported where necessary by active interventions for RRMS that are increasingly evidence based.
沙特阿拉伯王国（KSA）超过半数的多发性硬化症（MS）患者为育龄期女性。组建家庭是我们这个世界区域女性的一项重要生活目标。然而，对复发缓解型多发性硬化症（RRMS）临床病程以及疾病修正药物（DMDs）对胎儿影响的恐惧和误解，导致许多女性降低了组建家庭的期望，有时甚至完全避免怀孕。用于治疗RRMS的DMDs数量增加以及近期关于其在孕期影响的研究，拓宽了这些女性的管理选择。干扰素β目前在欧洲有孕期使用指征（根据临床需要），并且可在哺乳期使用。对于RRMS疾病活动程度较低且正在怀孕或即将怀孕的女性，醋酸格拉替雷是另一种可能的选择；对于疾病活动程度较高的患者，那他珠单抗可在孕30周前使用。在可能的情况下，医生需要支持并鼓励女性追求充实的家庭生活梦想，必要时通过对RRMS越来越多基于证据的积极干预措施来提供支持。
