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Family planning, antenatal and post partum care in multiple sclerosis: a review and update

Anneke Van Der Walt, Ai‐Lan Nguyen and Vilija Jokubaitis
Med J Aust 2019; 211 (5): . || doi: 10.5694/mja2.50113
Published online: 1 April 2019

Summary

 

  • Multiple sclerosis is more prevalent in women of childbearing age than in any other group. As a result, the impact of multiple sclerosis and its treatment on fertility, planned and unplanned pregnancies, post partum care and breastfeeding presents unique challenges that need to be addressed in everyday clinical practice.
  • Given the increasing number of disease‐modifying agents now available in Australia for the treatment of multiple sclerosis, there is a growing need for clinicians to provide their patients with appropriate counselling on family planning.
  • Providing better evidence regarding the relative risks and benefits of continuing therapy before, during and after pregnancy is an important research priority. International pregnancy registries are essential in developing better evidence‐based practice guidelines, and neurologists should be encouraged to contribute to these when possible.
  • The management of women with multiple sclerosis, especially when they are taking disease‐modifying agents, requires careful assessment of fertility and disease characteristics as well as a multidisciplinary approach to ensure positive outcomes in both mothers and their children.

 

  • Anneke Van Der Walt1,2,3,4
  • Ai‐Lan Nguyen2,4
  • Vilija Jokubaitis1,2,3

  • 1 Monash University, Melbourne, VIC
  • 2 University of Melbourne, Melbourne, VIC
  • 3 Alfred Health, Melbourne, VIC
  • 4 Royal Melbourne Hospital, Melbourne, VIC


Competing interests:

Anneke Van der Walt has received travel support, speaking honoraria and served on advisory boards for Biogen Australia, Novartis, Merck, Sanofi, Roche and Teva. Ai‐Lan Nguyen has received grant support and travel support from Biogen Australia. Vilija Jokubaitis has received travel support and speaking honoraria from Biogen Australia.

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