Fetal risks related to the treatment of multiple sclerosis during pregnancy and breastfeeding

Abstract

In women with multiple sclerosis, pregnancy does not have a long-term adverse effect on lifetime disability; however, there is an increased risk of relapses during the postpartum. Therapies taken during pregnancy may have adverse effects on pregnancy outcome. The small number of pregnancies included in most studies, particularly those evaluating the risks related to the administration of immunomodulating drugs, do not allow firm conclusions to be drawn with regards to their safety. Therefore, until more information regarding safety is available, glatiramer acetate, mitoxantrone and interferon-β should be discontinued before an anticipated pregnancy. By contrast, glucocorticoids can be used to treat acute relapses during pregnancy.

Keywords::

• azathioprine
• cyclophosphamide
• glatiramer acetate
• glucocorticoids
• immunoglobulin
• interferon-β-1
• intravenous
• methotrexate
• mitoxantrone
• multiple sclerosis
• pregnancy