What can we really tell women with multiple sclerosis regarding pregnancy? A systematic review and meta-analysis of the literature
- 15 March 2011
- journal article
- review article
- Published by Wiley in BJOG: An International Journal of Obstetrics and Gynaecology
- Vol. 118 (7), 790-797
- https://doi.org/10.1111/j.1471-0528.2011.02931.x
Abstract
Please cite this paper as: Finkelsztejn A, Brooks J, Paschoal F, Fragoso Y. What can we really tell women with multiple sclerosis regarding pregnancy? A systematic review and meta‐analysis of the literature. BJOG 2011;118:790–797. Background Although several papers report on pregnancy and multiple sclerosis (MS), no systematic review of the literature has been carried out. Neurologists and obstetricians need to have proper information to discuss with women presenting with MS who consider pregnancy. Objectives Literature review and meta‐analysis of data on pregnancy in women with MS. Search strategy The present work followed the recommendations of the PRISMA Statement. Using the PICO framework, the authors independently searched for the terms ‘pregnancy’ OR ‘gestation’ OR ‘pregnant’ AND ‘multiple sclerosis’ OR ‘MS’ in the following databases: EMBASE/Excerpta Medica, Medline, Pubmed, Scopus, Index Medicus, Biomed Central, Ebsco Fulltext, LILACS, Scielo and the Cochrane Database of Systematic Reviews. Selection criteria: only papers presenting original work with analysis of at least one of the outcomes among pregnant women with MS were included. Data collection and analysis Two independent workers performed the literature review. All the authors selected and read the relevant papers. Two other authors summarised data for analysis. Main results Twenty‐two papers reporting on 13 144 women with MS and their pregnancies were analysed. A significant decrease in relapse rate was observed during pregnancy, followed by a significant increase after delivery. Miscarriages, low birthweight, prematurity, neonatal death and malformations were assessed among these women and their offspring. There seems to be a regional influence on the rates of caesarean sections and abortions among women with MS. Neonatal death and malformation rates did not seem to be particularly high. Authors’ conclusions The present work provides evidence‐based data that can be discussed with women with MS and their relatives when pregnancy is considered by these families.Keywords
This publication has 28 references indexed in Scilit:
- Obstetric outcomes in women with multiple sclerosis and epilepsyNeurology, 2009
- Does multiple sclerosis increase risk of adverse pregnancy outcomes? A population-based studyMultiple Sclerosis Journal, 2009
- Epidemiological characteristics of pregnancy, delivery, and birth outcome in women with multiple sclerosis in Argentina (EMEMAR study)Multiple Sclerosis Journal, 2009
- Reproductive counselling, treatment and course of pregnancy in 73 German MS patientsActa Neurologica Scandinavica, 2008
- Pregnancy in multiple sclerosis patients treated with immunomodulators prior to or during part of the pregnancy: a descriptive study in the Spanish populationMultiple Sclerosis Journal, 2007
- Utilization of the PICO framework to improve searching PubMed for clinical questionsBMC Medical Informatics and Decision Making, 2007
- Planned vaginal births in women with multiple sclerosis: delivery and birth outcomeActa Neurologica Scandinavica, 2006
- Pregnancy and multiple sclerosis: a longitudinal study of 125 remittent patients.Journal of Neurology, Neurosurgery & Psychiatry, 1993
- Risk of multiple sclerosis exacerbation during pregnancy and breast-feedingJAMA, 1988
- New diagnostic criteria for multiple sclerosis: Guidelines for research protocolsAnnals of Neurology, 1983