Pregnancy in multiple sclerosis women with relapses in the year before conception increases the risk of long-term disability worsening
| Autor: | Emilio Portaccio, Laura Tudisco, Luisa Pastò, Lorenzo Razzolini, Mattia Fonderico, Angelo Bellinvia, Angelo Ghezzi, Pietro Annovazzi, Mauro Zaffaroni, Lucia Moiola, Vittorio Martinelli, Clara Grazia Chisari, Francesco Patti, Gianluigi Mancardi, Carlo Pozzilli, Laura De Giglio, Rocco Totaro, Alessandra Lugaresi, Valeria Di Tommaso, Damiano Paolicelli, Eleonora Cocco, Maria Giovanna Marrosu, Giancarlo Comi, Massimo Filippi, Maria Trojano, Maria Pia Amato, Clara Guaschino, Alessandra Protti, Chiara Spreafico, Raffaella Marazzi, Paola Cavalla, Roberto Bergamaschi, Claudio Solaro, Luisa Maria Caniatti, Maria Rosaria Tola, Franco Granella, Paolo Immovilli, Pasquale Annunziata, Katrin Plewnia, Maria Letizia Bartolozzi, Leonello Guidi, Monica Mazzoni, Giovanna De Luca, Luigina Musu, Salvatore Lo Fermo |
|---|---|
| Přispěvatelé: | Portaccio, Emilio, Tudisco, Laura, Pastò, Luisa, Razzolini, Lorenzo, Fonderico, Mattia, Bellinvia, Angelo, Ghezzi, Angelo, Annovazzi, Pietro, Zaffaroni, Mauro, Moiola, Lucia, Martinelli, Vittorio, Chisari, Clara Grazia, Patti, Francesco, Mancardi, Gianluigi, Pozzilli, Carlo, De Giglio, Laura, Totaro, Rocco, Lugaresi, Alessandra, Di Tommaso, Valeria, Paolicelli, Damiano, Cocco, Eleonora, Marrosu, Maria Giovanna, Comi, Giancarlo, Filippi, Massimo, Trojano, Maria, Amato, Maria Pia, Guaschino, Clara, Protti, Alessandra, Spreafico, Chiara, Marazzi, Raffaella, Cavalla, Paola, Bergamaschi, Roberto, Solaro, Claudio, Caniatti, Luisa Maria, Tola, Maria Rosaria, Granella, Franco, Immovilli, Paolo, Annunziata, Pasquale, Plewnia, Katrin, Bartolozzi, Maria Letizia, Guidi, Leonello, Mazzoni, Monica, De Luca, Giovanna, Musu, Luigina, Fermo, Salvatore Lo, DIPARTIMENTO DI SCIENZE BIOMEDICHE E NEUROMOTORIE |
| Rok vydání: | 2022 |
| Předmět: |
2019-20 coronavirus outbreak
Pediatrics medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Multiple sclerosis disability worsening pregnancy 03 medical and health sciences Disability Evaluation 0302 clinical medicine Multiple Sclerosis Relapsing-Remitting Recurrence medicine Humans Disabled Persons 030212 general & internal medicine Pregnancy business.industry Long term disability medicine.disease Neurology Italy Disease Progression Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Popis: | none 26 no Background: The influence of pregnancy on long-term disability in multiple sclerosis (MS) is still controversial. Objective: To assess the risk of long-term disability worsening after pregnancy in MS women as compared with a propensity-score (PS) matched group of MS women without pregnancy. Methods: In the setting of the Italian Pregnancy Dataset, MS patients with (pregnancy group (PG)) and without pregnancy (control group (CG)) were recruited. Time to disability worsening on the Expanded Disability Status Scale (EDSS) was assessed through a multivariable Cox regression model. Results: The PS-matching retained 230 PG and 102 CG patients. After a follow-up of 6.5 +/- 3.1 years, disability worsening occurred in 87 (26.2%) women. In the multivariable analysis, disability worsening was associated with pregnancy in women with relapses in the year before conception (adjusted hazard ratio (aHR) = 1.74; 95% confidence interval (CI) 1.06-2.84; p = 0.027), higher EDSS (aHR = 1.39; 95% CI 1.12-1.74; p = 0.003), younger age (aHR = 0.95; 95% CI 0.91-0.99; p = 0.022) and shorter DMD exposure over the follow-up (p < 0.008). Conclusion: Pregnancy in MS women with relapses in the year before conception increases the risk of long-term disability worsening. Our findings underscore the importance of counselling in MS women facing a pregnancy that should be planned after a period of clinical stability, favouring treatment optimization in patients with recent disease activity. mixed Portaccio, Emilio; Tudisco, Laura; Pastò, Luisa; Razzolini, Lorenzo; Fonderico, Mattia; Bellinvia, Angelo; Ghezzi, Angelo; Annovazzi, Pietro; Zaffaroni, Mauro; Moiola, Lucia; Martinelli, Vittorio; Chisari, Clara Grazia; Patti, Francesco; Mancardi, Gianluigi; Pozzilli, Carlo; De Giglio, Laura; Totaro, Rocco; Lugaresi, Alessandra; Di Tommaso, Valeria; Paolicelli, Damiano; Cocco, Eleonora; Marrosu, Maria Giovanna; Comi, Giancarlo; Filippi, Massimo; Trojano, Maria; Amato, Maria Pia Portaccio, Emilio; Tudisco, Laura; Pastò, Luisa; Razzolini, Lorenzo; Fonderico, Mattia; Bellinvia, Angelo; Ghezzi, Angelo; Annovazzi, Pietro; Zaffaroni, Mauro; Moiola, Lucia; Martinelli, Vittorio; Chisari, Clara Grazia; Patti, Francesco; Mancardi, Gianluigi; Pozzilli, Carlo; De Giglio, Laura; Totaro, Rocco; Lugaresi, Alessandra; Di Tommaso, Valeria; Paolicelli, Damiano; Cocco, Eleonora; Marrosu, Maria Giovanna; Comi, Giancarlo; Filippi, Massimo; Trojano, Maria; Amato, Maria Pia |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|