Date: January 2, 2025

In a groundbreaking study published in The Lancet Regional Health: Europe, researchers have unveiled alarming connections between disease-modifying therapies (DMTs) for multiple sclerosis (MS) and adverse pregnancy outcomes. This research, led by Nadine Bast from Ruhr University Bochum in Germany, sheds light on concerns that could significantly impact women with MS who are planning to conceive.

The study meticulously analyzed pregnancy and neonatal outcomes involving nearly 3,000 pregnancies exposed to DMTs and compared them to over 800 non-exposed cases. While the findings revealed that DMT exposure was not linked to spontaneous abortions, preterm births, or major congenital anomalies, some disconcerting trends were identified.

For instance, mothers who had been treated with fumarates experienced nearly three times the rate of severe infections compared to those who were not treated (2.8% vs. 1.0%). Furthermore, notable increases in systemic antibiotic use were associated with second-trimester and third-trimester exposure to natalizumab and anti-CD20 therapies, suggesting potential complications for mothers and newborns alike.

What’s particularly concerning is the observed reduction in birth weight among babies born to mothers in the sphingosine-1-phosphate and third-trimester natalizumab categories. Babies in these groups weighed significantly less than their peers, with a decrease of up to 132 grams linked to sphingosine-1-phosphate exposure. The study also found that neonates in these medication categories were more likely to be classified as small for gestational age, with rates reaching 65% compared to just 10% in the general German population.

The authors stress the importance of these findings in shaping future pregnancy recommendations for women with MS. They emphasize the urgent need for more comprehensive data as they aim to enhance the quality of care and guidance for expecting mothers battling this chronic condition.

While this study was funded by pharmaceutical companies, and several authors acknowledged their relationships with the industry, the implications of this research cannot be overlooked, especially as more women with MS explore their options for motherhood.

Are We Prepared?

As the medical community navigates the complex landscape of MS treatment during pregnancy, this study raises vital questions: What changes need to be made in treatment protocols? Are healthcare professionals equipped to give the best advice to their patients? The future for MS patients who wish to conceive could depend on the answers to these pressing issues. Stay tuned for more updates!