Article Text
Abstract
Multiple sclerosis (MS) is more common in women than men and is most commonly diagnosed in early adulthood; thus, many patients will not have completed their families at the time of diagnosis. There is increasing awareness of the importance of early treatment in preventing long-term disability in MS. Delaying treatment until women with MS have completed their families can lead to the development of irreversible disability in at least some cases. It is therefore important to discuss family planning and pregnancy proactively. However, to date there is limited evidence to inform such discussions. We set out to develop consensus guidelines for the treatment of MS in pregnancy to encourage and facilitate discussions in this important area. The guidelines draw on available evidence from drug-specific pregnancy registers and published literature and have been scored by a panel of experts from a variety of disciplines using modified Delphi criteria. They cover prepregnancy counselling, management during pregnancy, delivery and anaesthetic options, postpartum advice and specific advice regarding currently licensed disease-modifying drugs. As the complexity and range of available disease-modifying drugs increase, further data gathering via a UK-wide MS pregnancy register is recommended.
- multiple sclerosis
- pregnancy
- disease modifying therapy
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Footnotes
Contributors PD, PAB and GG conceived the idea of the guidelines. PAB, PD and MR developed the working group discussion into guidelines for the review process and revised these in response to initial review. RD, PAB, PD and CN-P developed the working group recommendations into the guideline format. RD drafted the initial paper for dissemination and incorporated further feedback from all authors and the wider working group. All authors provided input into the final manuscript.
Funding The project was supported by the MS Trust.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Provenance and peer review. Commissioned. Externally peer reviewed by Emma Tallantyre, Cardiff, UK.
Addendum Following the publication of ‘UK consensus on pregnancy in multiple sclerosis: ABN guidelines’, new information has become available. Further information is available at
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