Patterns of MS activity before, during and after pregnancy
Accumulating data suggest that pregnancy does not impact the natural course of relapsing MS or the progression of disability over the long term [1-4].
Risk of relapse typically decreases during pregnancy (especially within the third trimester) and increases immediately after delivery [1-3,5,6]. However, the postpartum increase in relapse risk seems to be less pronounced in contemporary cohorts [6,7]. This may be a result of early resumption of therapy after delivery, particularly in patients with active pre-pregnancy disease . Resuming therapy postpartum and breastfeeding are no longer seen as mutually exclusive. Since 2019, interferon beta including BETAFERON can be taken while breastfeeding .
The pathophysiologic basis for the protective effect of pregnancy on MS activity is poorly understood . In general, the maternal immune system plays a critical role in the establishment, maintenance, and completion of a healthy pregnancy. During pregnancy, immune regulations are induced by a unique combination of paternal antigens, hormones, and other factors to prevent the rejection of an allogeneic fetus, while still providing protective immunity to both mother and fetus [9,10].
A study has found that successive pregnancies followed a similar or milder pattern of MS activity compared with their first pregnancy .
The patterns of MS activity before, during and after pregnancy may be influenced by therapy prior to pregnancy [6,12,13]. Withdrawing some therapies before trying to conceive can result in a treatment gap lasting an uncertain period of time, risking a rebound of disease activity [5,11,14].
This effect has not been observed for interferon beta [6,12]. Patients who take an interferon beta like BETAFERON up until pregnancy is confirmed may experience a reduced risk of relapses during pregnancy and a peak risk early after delivery [6,12]. Postpartum relapse risk may be attenuated by early resumption of MS therapy . More women may choose this option as breastfeeding and resumption of MS therapy are no longer considered mutually exclusive. As of 2019, interferon beta including BETAFERON can be taken during breastfeeding .
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