Pregnancy planning and outcomes in patients with multiple sclerosis after mitoxantrone therapy: a monocentre assessment
| Autor: | Claudia Sardu, Eleonora Cocco, P. Casanova, Giancarlo Coghe, Giuseppe Fenu, Lorena Lorefice, Jessica Frau, Mg Marrosu |
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| Rok vydání: | 2018 |
| Předmět: |
Infertility
Adult Male medicine.medical_specialty Multiple Sclerosis Abortion Patient Care Planning Miscarriage Pregnancy planning Cohort Studies 03 medical and health sciences Disability Evaluation 0302 clinical medicine Pregnancy medicine Humans Topoisomerase II Inhibitors In patient Prospective Studies Mitoxantrone 030219 obstetrics & reproductive medicine business.industry Obstetrics Multiple sclerosis Infant Newborn Pregnancy Outcome medicine.disease Abortion Spontaneous Fertility Neurology Quality of Life Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | European journal of neurology. 25(8) |
| ISSN: | 1468-1331 |
| Popis: | BACKGROUND AND PURPOSE Patients with multiple sclerosis (MS) have many pregnancy-related doubts and fears. Careful counselling is thus important. Mitoxantrone (MITO) is used in patients with aggressive MS and may affect reproductive capacity. The aim of this study was to investigate pregnancy planning and outcomes in patients with MS treated with MITO, both before and after the treatment. METHODS Patients with MS previously treated with MITO were recruited. Clinical, demographic and treatment data were recorded. A questionnaire regarding the planning and outcomes of all pregnancies was administered. Parametric and non-parametric tests were performed using SPSS 22 software. RESULTS A total of 238 patients (female/male, 158/80) were included; 106 subjects planned a pregnancy before MITO and 40 after MITO. Of these, respectively, 102 (97%) and 35 (85%) resulted in conception, 19 (19%) and 7 (18%) in miscarriage, 6 (6%) and 1 (3%) in abortion and 98 (96%) and 32 (91%) were full-term pregnancies. A total of 96 patients (40%) planned a pregnancy only before MITO (and not after), whereas 30 (13%) planned a pregnancy only after MITO (and not before) (P < 0.01). A total of 103 patients did not plan a pregnancy before MITO and 198 did not plan a pregnancy after MITO. The reasons included lack of interest or a partner, fear of MS and infertility. All of the babies born were healthy until the end of follow-up. CONCLUSIONS Mitoxantrone does not affect the ability to conceive or pregnancy outcomes. We found no differences in pregnancies, abortions or miscarriages before and after MITO. The tendency to plan pregnancies decreased significantly after MITO. Our findings may be useful for improving the quality of life of patients and the approach taken by neurologists. |
| Databáze: | OpenAIRE |
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