Reproductive health of women with multiple sclerosis

Cover Page


Cite item

Full Text

Abstract

Organic diseases of the central nervous system (CNS) are of utmost importance in the formation of gynecological pathology. Multiple sclerosis (MS) and mmunomodifying therapy which is in use in patients with this disease have a significant effect on menstrual and reproductive functions, pregnancy and delivery in women with MS. Infertility in patients with MS is due, on the one hand, to psychological and sexual problems and, on the other hand, to the secondary gonadal failure. Obstetric outcomes in women with MS do not differ significantly from those in the general population, but some specific characteristics of the course of  pregnancy and delivery need attention and multidisciplinary approach.

About the authors

O. A. Tikhonovskaya

Siberian State Medical University

Author for correspondence.
Email: tikhonovskaya2012@mail.ru
Russian Federation, Tomsk

A. Y. Pinchuk

Siberian State Medical University

Email: tikhonovskaya2012@mail.ru
Russian Federation, Tomsk

V. M. Alifirova

Siberian State Medical University

Email: tikhonovskaya2012@mail.ru
Russian Federation, Tomsk

N. F. Musina

Siberian State Medical University

Email: tikhonovskaya2012@mail.ru
Russian Federation, Tomsk

References

  1. Белова А.Н., Качалина Т.С., Крупин В.Н. и др. Рассеянный склероз и беременность. Неврол. журн. 2010; 6: 4–10.
  2. Кучерова И.В. Состояние репродуктивной системы у женщин, страдающих неврозом. Автореф. Дис. канд. мед. наук. М., 1989.
  3. Предтеченская Е.В., Некрасова М.Ф. Половые гормоны в патогенезе рассеянного склероза. Нейроиммунология 2011; 3–4:129–130.
  4. Шмидт Т.Е., Яхно Н.Н. Рассеянный склероз: руководство для врачей. М.: МЕД-пресс-информ, 2010.
  5. Achiron A., Kishner I., Dolev M. et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J. Neurol. 2004; 251: 1133–1137.
  6. Amato M.P., Portaccio E., Ghezzi A. MS Study Group of the Italian Neurological Society: Pregnancy and fetal outcomes after interferon-β exposure in multiple sclerosis. Neurology 2010; 75: 1794–1802.
  7. Avonex (intramuscular interferon beta-1a) prescribing information (2011) http://www.avonex.com/pdfs/guides/Avonex_Prescribing_Information.pdf
  8. Bayas A., Penzien J., Hellwig K. Accidental natalizumab administration to the third trimester of pregnancy in an adolescent patient with multiple sclerosis. Acta. Neurol. Scand. 2011; 124: 290–292.
  9. Betaseron (interferon beta-1b) prescribing information (2011)http://labeling.bayerhealthcare.com/html/products/pi/Betaseron_PI.pdf
  10. Borisow N., Dцring A., Pfueller C.F. et al. Expert recommendations to personalization of medical approaches in treatment of multiple scle49 rosis: an overview of family planning and pregnancy. http://www.epmajournal.com/content/3/1/9/
  11. Boskovic R., Wide R., Wolpin J. et al. The reproductive effects of beta interferon therapy in pregnancy: a longitudinal cohort. Neurology 2005; 65: 807–811.
  12. Cavalla P., Rovei V., Masera S. et al. Fertility in patients with multiple sclerosis: current knowledge and future perspectives. Neurol. Sci. 2006; 27: 231–239.
  13. Chen Y.H., Lin H.L., Lin H.C. Does multiple sclerosis increase risk of adverse pregnancy outcomes? A population-based study. Mult. Scler. 2009; 15: 606–612.
  14. Cocco E., Sardu C., Gallo P. et al. and the FEMIMS group. Frequency and risk factors of mitoxantrone-induced amenorrhea in multiple sclerosis:the FEMIMS study. Mult. Scler. 2008; 14: 1225–1233.
  15. Confavreux C., Hutchinson M., Hours M.M. et al. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in multiple sclerosis group. N. Engl. J. Med. 1998; 339: 285–291.
  16. Copaxone (glatiramer acetate) prescribing information (2011)http://www.sharedsolutions.com/pdfs/prescribinginformation.aspx
  17. Coyle P.K., Christie S., Fodor P. et al. Multiple sclerosis gender issues: clinical practices of women neurologists. Mult. Scler. 2004; 10:582–588.
  18. Dahl J., Myhr K.M., Daltveit A.K. et al. Pregnancy, delivery and birth outcome in different stages of maternal multiple sclerosis. J. Neurol.2008; 255: 623–627.
  19. Dahl J., Myhr K.M., Daltveit A.K. et al. Pregnancy, delivery, and birth outcome in women with multiple sclerosis. Neurology 2005; 65:1961–1963.
  20. De Santis M., Straface G., Cavaliere A.F. et al. The first case of mitoxantrone exposure in early pregnancy. Neurotoxicology 2007; 28:696–697.
  21. De Seze J., Chapelotte M., Delalande S. et al. Intravenous corticosteroids in the postpartum period for reduction of acute exacerbations in multiple sclerosis. Mult. Scler. 2004; 10: 596–597.
  22. Demirkiran M., Sarica Y., Uguz S. et al. Multiple sclerosis patients with and without sexual dysfunction: are there any differences? Mult. Scler. 2006; 12: 209–214.
  23. Di Cosimo S., Alimonti A., Ferretti G. et al. Incidence of chemotherapy-induced amenorrhea depending on the timing of treatment by menstrual cycle phase in women with early breast cancer. Ann. Oncol. 2004; 15: 1065–1071.
  24. Falaschi P., Martocchia A., Proietti A. et al. High incidence of hyperandrogenism-related clinical signs in patients with multiple sclerosis. Neuro. Endocrinol. Lett, 2001; 22: 248–250.
  25. Ferrero S., Esposito F., Pretta S. et al. Fetal risks related to the treatment of multiple sclerosis during pregnancy and breastfeeding. Exp. Rev. Neurotherapeutics 2006; 6: 1823–1831.
  26. Ferrero S., Pretta S., Ragni N. Multiple sclerosis: management issues during pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2004; 115: 3–9.
  27. Finkelsztejn A., Brooks J.B., Paschoal F.M. Jr. et al. 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.
  28. Fragoso Y.D., Finkelsztejn A., Kaimen-Maciel D.R. et al. Long-term use of glatiramer acetate by 11 pregnant women with multiple sclerosis: a retrospective, multicentre case series. CNS Drugs 2010; 24: 969–976.
  29. Gilenya (fingolimod) US prescribing information (2011)http://www.pharma.us.novartis.com/cs/www.pharma.us.novartis.com/product/pi/pdf/gilenya.pdf
  30. Greenberger P.A., Odeh Y.K., Frederiksen M.C. et al. Pharmacokinetics of prednisolone transfer to breast milk. Clin. Pharmacol. Therapeut. 1993; 53: 324–328.
  31. Grinsted L., Heltberg A., Hagen C. et al. Serum sex hormone and gonadotropin concentrations in premenopausal women with multiple sclerosis. J. Intern. Med. 1989; 226: 241–244.
  32. Gur C., Diav-Citrin O., Shechtman S. et al. Pregnancy outcome after first trimester exposure to corticosteroids: a prospective controlled study. Reprod. Toxicol. 2004; 18: 93–101.
  33. Haas J., Hommes O.R. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult. Scler. 2007; 13:900–908.
  34. Hellwig K., Agne H., Gold R. Interferon beta, birth weight and pregnancy in multiple sclerosis. J. Neurol. 2009; 256: 830–831.
  35. Hellwig K., Brune N., Haghikia A. et al. Reproductive counseling, treatment and course of pregnancy in 73 German MS patients. Acta. Neurol. Scand. 2008; 118: 24–28.
  36. Hellwig K., Gold R. Glatiramer acetate and interferon-beta throughout gestation and postpartum in women with multiple sclerosis. J. Neurol. 2011; 258: 502–503.
  37. Hellwig K., Haghikia A., Agne H. et al. Protective effect of breastfeeding in postpartum relapse rate of mothers with multiple sclerosis. Arch. Neurol. 2009; 66: 1580–1581.
  38. Hellwig K., Haghikia A., Gold R. Multiple sclerosis and pregnancy experience from a nationwide database. Neurology 2011; 76 (Suppl 4):A273.
  39. Hellwig K., Haghikia A., Gold R. Pregnancy and natalizumab: results of an observational study in 35 accidental pregnancies during natalizumab treatment. Mult. Scler. 2011; 17: 958–963.
  40. Hellwig K., Kuge M., Gold R. et al. Exclusive breastfeeding reduces the risk of postpartum relapses a prospective study from the German MS and pregnancy registry. Neurology 2011; 76 (Suppl. 4): A273.
  41. Hellwig K., Schimrigk S., Chan A. et al. A newborn with Pierre Robin sequence after preconceptional mitoxantrone exposure of a female with multiple sclerosis. J. Neurol. Sci. 2011; 307: 164–165.
  42. Hoes J.N., Jacobs J.W., Boers M. et al. EULAR evidencebased recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Annals Rheumatic Dis. 2007; 66: 1560–1567.
  43. Hoevenaren I.A., de Vries L.C., Rijnders R.J. et al. Delivery of healthy babies after natalizumab use for multiple sclerosis: a report of two cases. Acta. Neurol. Scand. 2011; 123: 430–433.
  44. Houtchens M.K., Kolb C.M. Multiple sclerosis and pregnancy: therapeutic considerations. J. Neurol. 2013; 260: 1202–1214.
  45. Jalkanen A., Alanen A., Airas L. Finnish Multiple Sclerosis and Pregnancy Study Group: Pregnancy outcome in women with multiple sclerosis: results from a prospective nationwide study in Finland. Mult. Scler. 2010; 16: 950–955.
  46. Jalkanen A., Airas L., Marttila R.J. To breastfeed or not to breastfeed: effect of breastfeeding on postpartum disease activity in multiple sclerosis revisited. Neurology 2011; 76 (Suppl 4): A610.
  47. Kelly V.M., Nelson L.M., Chakravarty E.F. Obstetric outcomes in women with multiple sclerosis and epilepsy. Neurol. 2009; 73: 1831–1836.
  48. Langer-Gould A., Huang S.M., Gupta R. et al. Exclusive breastfeeding and the risk of postpartum relapses in women with multiple sclerosis. Arch. Neurol. 2009; 66: 958–963.
  49. Mueller B.A., Zhang J., Critchlow C.W. Birth outcomes and need for hospitalization after delivery among women with multiple sclerosis. Am. J. Obstet. Gynecol. 2002; 186: 446–452.
  50. Nelson L.M., Franklin G.M., Jones M.C. Risk of multiple sclerosis exacerbation during pregnancy and breast-feeding. JAMA 1988; 259:3441–3443.
  51. Novantrone (mitoxantrone) prescribing information (2011) http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019297s030s031lbl.pdf
  52. Nurmohamed L., Moretti M.E., Schechter T. et al. Outcome following high-dose methotrexate in pregnancies misdiagnosed as ectopic. Am. J. Obstet. Gynecol. 2011; 205: 533.e1–533.e3.
  53. Park-Wyllie L., Mazzotta P., Pastuszak A. et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology 2000; 62: 385–392.
  54. Patti F., Cavallaro T., Lo Fermo S. et al. Is in utero early-exposure to interferon beta a risk factor for pregnancy outcomes in multiple sclerosis? J. Neurol. 2008; 255: 1250–1253.
  55. Portaccio E., Ghezzi A., Hakiki B. et al. Breastfeeding is not related to postpartum relapses in multiple sclerosis. Neurology 2011; 77:145–150.
  56. Rebif (subcutaneous interferon beta-1a) prescribing information (2011) http://www.emdserono.com/cmg.emdserono_us/en/images/rebif_tcm115_19765.pdf.
  57. Salminen H.J., Leggett H., Boggild M. Glatiramer acetate exposure in pregnancy: preliminary safety and birth outcomes. J. Neurol. 2010; 257: 2020–2023.
  58. Sandberg-Wollheim M., Alteri E., Moraga M.S. et al. Pregnancy outcomes in multiple sclerosis following subcutaneous interferon beta-1a therapy. Mult. Scler. 2011; 17: 423–430.
  59. Sandberg-Wollheim M., Frank D., Goodwin T.M. et al. Pregnancy outcomes during treatment with interferon beta-1a in patients with multiple sclerosis. Neurology 2005; 65: 802–806.
  60. Sellner J., Kraus J., Awad A. et al. The increasing incidence and prevalence of female multiple sclerosis – a critical analysis of potential environmental factors. Autoimmun. Rev. 2011; 10: 495–502.
  61. Sipski M.L., Behnegar A. Neurogenic female sexual dysfunction: a review. Clin. Auton. Res. 2001; 11: 279–283.
  62. Tomassini V., Onesti E., Mainero C. et al. Sex hormones modulate brain damage in multiple sclerosis: MRI evidence. J. Neurol. Neurosurg. Psychiatry 2005; 76: 272–275.
  63. Tysabri (natalizumab) European public assessment report (2011) http://www.ema.europa.eu/ema/index.jspcurl=pages/medicines/human/medicines/000603/human_med_001119.jsp&mid=WC0b01ac058001d124
  64. Tysabri (natalizumab) prescribing information (2011) http://www.tysabri.com/pdfs/I61061-13_PI.pdf
  65. Van der Kop M.L., Pearce M.S., Dahlgren L. et al. Neonatal and delivery outcomes in women with multiple sclerosis. Ann. Neurol. 2011; 70: 41–50.
  66. Vukusic S., Confavreux C. Pregnancy and multiple sclerosis: the children of PRIMS. Clin. Neurol. Neurosurg. 2006; 108: 266–270.
  67. Weber-Schoendorfer C., Schaefer C. Multiple sclerosis, immunomodulators, and pregnancy outcome: a prospective observational study. Mult. Scler. 2009; 15: 1037–1042.
  68. Zorzon M., Zivadinov R., Bosco A. et al. Sexual dysfunction in multiple sclerosis: a case–control study. I. Frequency and comparison of groups. Mult. Scler. 1999; 5: 418–427.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2014 Tikhonovskaya O.A., Pinchuk A.Y., Alifirova V.M., Musina N.F.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-83204 от 12.05.2022.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies