Publikation
Role of family planning in women of child-bearing age with multiple sclerosis (MS) in Switzerland: Results of the Women
Konferenzpapier/Poster - 17.04.2016
Muehl Sarah, Czaplinski Adam, Stelmess Petra, Kamm Christian P., Müller Stefanie
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OBJECTIVE: The WWMS patient survey aimed to improve understanding of factors which affect family planning in women of child-bearing age with MS.
BACKGROUND: Many women with MS are of child-bearing age and may desire to conceive.
METHODS: Women with MS, aged 18-50 years, at 15 centres in Switzerland were surveyed.
RESULTS: Between September 2014 and August 2015, 271 females (79.3% [n=215] of child-bearing age [18–45 years]), who had CIS (n=7), RRMS (n=249), SPMS (n=6) or not known (n=9), regardless of MS treatment, completed the WWMS survey. Overall, a total of 39.1% (n=106) women were pregnant or wanted children (1.5% [n=4] pregnant, 21.4% [n=58] short-term desire [std], 16.2% [n=44] medium-term desire [mtd]), 43.2% (n=117) had no desire (nd) for children and 17.7% (n=48) did not know (nk). Between age 18–45 years, 48.4% (n=104) wanted children or were pregnant. 92.3% (n=250) were treated with disease modifying therapy (DMT), and 7.7% (n=21) not treated with DMT (including the 4 women who were pregnant). Treatment included injectables (intramuscular IFN β-1a, subcutaneous IFN β-1b, subcutaneous IFN β-1a, glatiramer acetate) (nd n=19; std n=19; mtd n=9; nk n=7), orals (teriflunomide, fingolimod, dimethyl fumarate) (nd n=34; std n=13; mtd n=15; nk n=14), infusions (natalizumab) (nd n=41; std n=16; mtd n=14; nk n=17) and other (nd n=14; std n=6; mtd n=6; nk n=6). Oral treatment was significantly more common in women with no desire for children versus short- and medium-term desire (p<0.01 for both). In 15.3% (n=9) of women a previous pregnancy had been unplanned/unintended.
CONCLUSIONS: Over one-third of women with MS were pregnant or desired children, and nearly all received DMT independent of desire for children. The intention to have children within 2 years influenced treatment choice towards injectables over orals. Issues surrounding pregnancy influences therapy choice in women of child-bearing age with MS.