Neurológia pre prax 4/2014

Multiple sclerosis and pregnancy

Multiple sclerosis is an autoimmune inflammatory and neurodegenerative disease affecting young women of childbearing age. Owing to the knowledges and modern therapeutic approaches the illness can be really stable and women can carry out their biological role and have children. Maternal immune system undergoes profound transformations at the very beginning of pregnancy. The major changes are directed to protect the fetus from a detrimental immune response and the growing level of pregnancy hormones affects the mother´s immune reactions. According to the results of the clinical trials and long-term clinical experience the pregnancy has positive effect on the course of multiple sclerosis and the long term prognosis of the disease is not worsened due to pregnancy mainly in patients with relapsing type. Multiple sclerosis has little or no direct effect on fertility, mode of delivery and on neonatal health.

Keywords: multiple sclerosis, pregnancy, delivery, disease modulating drugs, breastfeeding, pregnancy hormones, fertility.