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Many women with multiple sclerosis (MS) ask about the risks of pregnancy before starting (or while on) disease-modifying therapies (DMTs). At least two-thirds of patients with MS are women, and the majority are in their childbearing years at the time of clinical onset and diagnosis. DMTs taken during pregnancy could have direct or indirect toxicity (through immunomodulating properties) on pregnancy outcome. High doses of interferon beta (IFNβ) are abortifacient in monkeys, but studies of teratogenicity in animals are limited by the rapid appearance of antibodies to human IFNβ (product information). Therefore, pregnancy outcome after in utero exposure to DMTs is important, particularly because DMTs are increasingly initiated early in the course of MS. In this issue of Neurology, two articles provide data on pregnancy outcome after in utero exposure to IFNβ.1,2
Sandberg-Wollheim et al.1 provide the first systematic and comprehensive analysis of pregnancy frequency and outcome, combining data from several randomized clinical trials of IFNβ-1a. Because allocation of treatment (IFNβ-1a at any dose vs …
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