Preventive Neurology Unit, Queen Mary University of London.
Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK.
Curr Opin Neurol. 2021 Jun 1;34(3):303-311. doi: 10.1097/WCO.0000000000000922.
The fact that multiple sclerosis (MS) predominantly affects women has been recognized for many years. As the age at diagnosis is decreasing, and treatment options are becoming more complex, increasing numbers of women are facing decisions about the use of disease modifying therapy (DMT) in and around pregnancy.
New data are rapidly becoming available, particularly regarding the safety of therapies in both pregnancy and breastfeeding. Effective treatment and suppression of relapses is key to ensuring good outcomes in the longer term for the woman, however this must be balanced against individual risk of relapse and risks to the fetus. Women should be advised that it is possible to breastfeed while taking selected DMT.
In this review, we discuss evidence surrounding the safety of DMTs in both pregnancy and breastfeeding, and use this knowledge to suggest approaches to pregnancy and family planning in women with MS.
多发性硬化症（MS）主要影响女性这一事实已被人们认识多年。随着诊断年龄的降低，以及治疗选择变得更加复杂，越来越多的女性在妊娠和哺乳期面临使用疾病修正治疗（DMT）的决策。
新数据正在迅速出现，特别是关于治疗方法在妊娠和哺乳期的安全性。有效的治疗和复发抑制是确保女性长期获得良好结局的关键，但这必须与复发的个体风险和对胎儿的风险相平衡。应告知女性，在服用某些 DMT 的同时进行母乳喂养是可能的。
在这篇综述中，我们讨论了 DMT 在妊娠和哺乳期的安全性证据，并利用这些知识提出了 MS 女性妊娠和计划生育的方法。
