{"id":2708,"date":"2021-11-28T11:14:00","date_gmt":"2021-11-28T10:14:00","guid":{"rendered":"https:\/\/www.multiplesclerosis.cz\/?p=2708"},"modified":"2025-08-20T08:52:58","modified_gmt":"2025-08-20T09:52:58","slug":"is-pregnancy-in-rs-patients-safe-and-what-is-the-effect-on-the-course-of-rs-real-findings-from-1-533-pregnancies-in-the-czech-republic","status":"publish","type":"post","link":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/2021\/11\/28\/je-tehotenstvi-u-pacientek-s-rs-bezpecne-a-jaky-ma-vliv-na-prubeh-rs-realne-poznatky-z-1-533-tehotenstvi-v-ceske-republice\/","title":{"rendered":"Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1,533 pregnancies in Czech Republic"},"content":{"rendered":"<div class=\"wp-block-group is-layout-grid wp-container-core-group-is-layout-478b6e6b wp-block-group-is-layout-grid\">\n<p class=\"wp-container-content-e29552f7\">Pregnancy in patients with multiple sclerosis (MS) requires special care, particularly with regard to decisions regarding disease-modifying disease (DMD) treatment and counselling regarding the period of conception, pregnancy and the postpartum period. This study aims to analyse the impact of pregnancy, childbirth or miscarriage on the course of multiple sclerosis in women with MS in the Czech Republic. The analysis was based on retrospective data from the Czech national registry <a href=\"https:\/\/www.multiplesclerosis.cz\/o-registru\/\" title=\"About the registry\">ReMuS <\/a>and includes data on 1 533 pregnancies. The results provide valuable insights into the safety of pregnancy for women with MS and how pregnancy and the postpartum period affect the course of the disease.<\/p>\n\n\n\t\t<div data-elementor-type=\"container\" data-elementor-id=\"4326\" class=\"elementor elementor-4326\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t<div class=\"elementor-element elementor-element-115cf7 e-flex e-con-boxed e-con e-parent\" data-id=\"115cf7\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3e4a8474 elementor-position-top elementor-widget elementor-widget-image-box\" data-id=\"3e4a8474\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"image-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img fetchpriority=\"high\" decoding=\"async\" width=\"400\" height=\"400\" src=\"\/wp-content\/uploads\/2025\/03\/mudr-pavel-hradilek.jpg\" class=\"attachment-full size-full wp-image-3868\" alt=\"\" srcset=\"\/wp-content\/uploads\/2025\/03\/mudr-pavel-hradilek.jpg 400w, \/wp-content\/uploads\/2025\/03\/mudr-pavel-hradilek-300x300.jpg 300w, \/wp-content\/uploads\/2025\/03\/mudr-pavel-hradilek-150x150.jpg 150w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/figure><div class=\"elementor-image-box-content\"><h3 class=\"elementor-image-box-title\">Pavel Hrad\u00edlek, MD, PH.D.<\/h3><p class=\"elementor-image-box-description\">University Hospital Ostrava<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n<\/div>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile is-vertically-aligned-top\" style=\"grid-template-columns:25% auto\"><figure class=\"wp-block-media-text__media\"><a href=\"https:\/\/doi.org\/10.1016\/j.msard.2021.103391\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" width=\"576\" height=\"768\" src=\"\/wp-content\/uploads\/2024\/08\/cover.tif-1.webp\" alt=\"\" class=\"wp-image-2709 size-full\" srcset=\"\/wp-content\/uploads\/2024\/08\/cover.tif-1.webp 576w, \/wp-content\/uploads\/2024\/08\/cover.tif-1-225x300.webp 225w\" sizes=\"(max-width: 576px) 100vw, 576px\" \/><\/a><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:15px\">Hradilek, P., Meluzinova, E., Zapletalova, O., Hanulikova, P., Horakova, D., Woznicova, I., Pavliska, L., Stetkarova, I., Valis, M., Stourac, P., Adamkova, J., Ampapa, R., Vachova, M., &amp; Mares, J. (2022). <em>Is pregnancy in MS patients safe and what is its impact on MS course? Real World evidence of 1533 pregnancies in Czech Republic<\/em>. In <strong>Multiple Sclerosis and Related Disorders <\/strong>(Vol. 59, p. 103391). Elsevier BV. <a href=\"https:\/\/doi.org\/10.1016\/j.msard.2021.103391\" target=\"_blank\" rel=\"noopener\" title=\"\">https:\/\/doi.org\/10.1016\/j.msard.2021.103391<\/a> PMID: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35240415\/\" target=\"_blank\" rel=\"noopener\" title=\"\">35240415<\/a><\/p>\n<\/div><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<p><strong>Introduction:<\/strong> Special care for women with multiple sclerosis (MS) who are planning a pregnancy is very challenging, especially when it comes to making decisions regarding disease-modifying treatment (DMD) and counselling regarding the conception, pregnancy and postpartum period.<\/p>\n\n\n\n<p><strong>Target:<\/strong> To provide data on the impact of pregnancy, childbirth or miscarriage\/abortion on the course of MS in Czech women with MS based on analysis of retrospective data from the Czech national ReMuS registry.<\/p>\n\n\n\n<p><strong>Methods:<\/strong> The analysis focused on women with MS who had at least one pregnancy record in the registry. Clinical data (EDSS, relapses) were collected before conception, during pregnancy and after delivery or miscarriage\/artificial termination of pregnancy. These data were analyzed by baseline characteristics of DMD treatment before conception and by breastfeeding status.<\/p>\n\n\n\n<p><strong>Results:<\/strong> A total of 1,533 pregnancies from 2013 to 31 December 2019 were analyzed. The incidence of relapses and worsening EDSS was significantly associated with treatment with escalation therapy before conception. Relapses were significantly more common in women who breastfed for less than 3 months than in women who breastfed for more than 3 months or did not breastfeed at all. Patients who were treated with fingolimod or natalizumab before pregnancy were significantly more likely to have relapses during pregnancy.<\/p>\n\n\n\n<p><strong>Conclusion:<\/strong> Pregnancy and the postpartum period were generally safe for Czech women with MS. Better outcomes were observed in those who were treated with first-line injectable DMDs before conception and in those who breastfed for more than 3 months or did not breastfeed at all. We confirmed the assumption of an MS rebound phenomenon after treatment discontinuation due to planned pregnancy, both for fingolimod and natalizumab.<\/p>\n\n\n\n<div class=\"wp-block-media-text is-vertically-aligned-center\" style=\"grid-template-columns:15% auto\"><figure class=\"wp-block-media-text__media\"><a href=\"https:\/\/doi.org\/10.1016\/j.msard.2021.103391\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/www.multiplesclerosis.cz\/wp-content\/uploads\/2023\/06\/lock-2_red.svg\" alt=\"\" class=\"wp-image-2975 size-thumbnail\"\/><\/a><\/figure><div class=\"wp-block-media-text__content\">\n<p>The full article is available in English by logging in to the journal's website <strong><a href=\"https:\/\/doi.org\/10.1016\/j.msard.2021.103391\" target=\"_blank\" rel=\"noopener\" title=\"\">Multiple Sclerosis and Related Disorders<\/a><\/strong>.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Pregnancy in patients with multiple sclerosis (MS) requires special care, particularly with regard to decisions regarding disease-modifying disease (DMD) treatment and counselling regarding the period of conception, pregnancy and the postpartum period. This study aims to analyze the impact of pregnancy, childbirth or miscarriage on the course of multiple sclerosis ...<\/p>","protected":false},"author":3,"featured_media":2984,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[4],"tags":[5],"class_list":["post-2708","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publikace","tag-medical-professionals-only"],"_links":{"self":[{"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/posts\/2708","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/comments?post=2708"}],"version-history":[{"count":1,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/posts\/2708\/revisions"}],"predecessor-version":[{"id":4511,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/posts\/2708\/revisions\/4511"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/media\/2984"}],"wp:attachment":[{"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/media?parent=2708"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/categories?post=2708"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/multiplesclerosis-app-aca9g6eranbfeyeg.northeurope-01.azurewebsites.net\/en\/wp-json\/wp\/v2\/tags?post=2708"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}