Department of Neurology, Royal Free Hospital UK.
Department of Neurology, Salford Royal NHS Foundation Trust UK.
Mult Scler Relat Disord. 2021 Nov;56:103272. doi: 10.1016/j.msard.2021.103272. Epub 2021 Sep 25.
The ABN Multiple Sclerosis (MS) pregnancy guidelines set out to combine best current evidence with expert consensus. They were developed to provide a practical framework to support neurologists when counselling women with MS regarding pregnancy. A key objective was to reduce variation in practice and increase clarity for patients in an area of uncertainty.
In order to assess the impact of these guidelines on practice, and assess ongoing areas of need, we conducted an online survey about MS and pregnancy. This survey was cascaded via email to UK neurologists between December 2019 and January 2020. Individuals completed this questionnaire anonymously.
The majority of respondents reported changing their prescribing practice with interferon-beta preparations (IFN-B) and natalizumab. The ABN guidelines were the most commonly cited reason for change (76%). However, there was considerable variation in advice regarding the use of both DMTs in pregnancy.
There is substantial variation in advice given to women with MS around pregnancy, and this is reflected in prescribing practice by UK Neurologists. Awareness of national guidelines is good, and these have driven change in a majority of MS neurologists. There remains the need to continually update and communicate these guidelines, particularly as recommendations evolve with increasing evidence.
ABN 多发性硬化症（MS）妊娠指南旨在结合最佳现有证据和专家共识。它们旨在为神经科医生在为 MS 女性提供妊娠咨询时提供一个实用的框架。一个主要目标是减少实践中的差异，并在一个不确定的领域为患者提供更清晰的信息。
为了评估这些指南对实践的影响，并评估持续存在的需求领域，我们进行了一项关于 MS 和妊娠的在线调查。这项调查通过电子邮件在 2019 年 12 月至 2020 年 1 月期间分发给英国神经科医生。个人匿名完成了这份问卷。
大多数受访者报告改变了他们使用干扰素-β制剂（IFN-B）和那他珠单抗的处方习惯。ABN 指南是改变处方的最常见原因（76%）。然而，在这两种 DMT 在妊娠期间的使用方面，建议存在相当大的差异。
在妊娠方面，为 MS 女性提供的建议存在很大差异，这反映在英国神经科医生的处方实践中。对国家指南的认识是良好的，这些指南已经推动了大多数 MS 神经科医生的改变。需要不断更新和传播这些指南，特别是随着证据的增加，建议也在不断发展。
