Document Detail

Epidemiological characteristics of pregnancy, delivery, and birth outcome in women with multiple sclerosis in Argentina (EMEMAR study).
MedLine Citation:
PMID:  19299437     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The influence of pregnancy on Multiple Sclerosis (MS) has been extensively studied but such influence on Latin American women with MS has not been characterized. Our objective was to describe the course of pregnancy and birth outcome in Argentinean MS patients and the evolution of MS during pregnancy and after delivery. METHOD: We used a retrospective design in eight MS centers in Argentina and administered a survey to women with definite MS (Mc Donald) with pregnancies during or after MS onset. We contacted 355 women of which 81 met inclusion criteria. We recorded 141 pregnancies. RESULTS: Involuntary abortion was observed in 16% of pregnancies (95% CI = 10-23). Thirty five women received immunomodulatory therapy (IMT) before 42 pregnancies. Twenty three (55%) out of 42 pregnancies were exposed to IMT. The mean time of IMT discontinuation before conception in 19 (45.2%) pregnancies without exposure, was 104 days (95% CI = 61.0-147.0). There were 103 deliveries: 79% full term. Birth defects were detected in 19% of pregnancies exposed to IMT (95% CI = 4-46) and in 2% of non-exposed (95% CI = 0.3-8.0). The mean relapse rate was: pre-pregnancy year: 0.22 (95% CI = 0.12-0.32); pregnancy: 0.31 in 1st (95% CI = 0.10-0.52), 0.19 (95% CI = 0.03-0.36) in 2nd, and 0.04 in 3rd trimester (95% CI = -0.04-0.12); 1st trimester post delivery: 0.82 (95% CI = 0.42-1.22). CONCLUSION: We observed a higher rate of birth defects among infants exposed to immunomodulators in utero than those not exposed. The reduction in MS relapses during 2nd and 3rd trimester of pregnancy and its increase during postpartum is consistent with previous reports.
N Fernández Liguori; D Klajn; L Acion; F Cáceres; A Calle; A Carrá; E Cristiano; N Deri; O Garcea; A Jaureguiberry; P Onaha; L Patrucco; P Riccio; R Rotta Escalante; M l Saladino; V Sinay; A Tarulla; A Villa
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-19
Journal Detail:
Title:  Multiple sclerosis (Houndmills, Basingstoke, England)     Volume:  15     ISSN:  1352-4585     ISO Abbreviation:  Mult. Scler.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9509185     Medline TA:  Mult Scler     Country:  England    
Other Details:
Languages:  eng     Pagination:  555-62     Citation Subset:  IM    
Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina.
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MeSH Terms
Argentina / epidemiology
Breast Feeding / statistics & numerical data
Congenital Abnormalities / epidemiology*
Data Collection
Delivery, Obstetric / statistics & numerical data*
Immunosuppressive Agents / therapeutic use
Infant, Newborn
Middle Aged
Multiple Sclerosis / drug therapy,  epidemiology*
Postpartum Period
Pregnancy Complications / epidemiology*
Pregnancy Outcome / epidemiology*
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Retrospective Studies
Risk Factors
Young Adult
Reg. No./Substance:
0/Immunosuppressive Agents

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