Neurol. praxi. 2019;20(1):33-36 | DOI: 10.36290/neu.2019.088

Multiple sclerosis – maternity and breastfeeding

MUDr. Olga Zapletalová
Neurologická klinika FN Ostrava, Lékařská fakulta OU, Ostrava

Multiple sclerosis (MS) is disease induced by immunopathogenetic autoimmune inflammation and neurodegenerative process, which demage central nervous system. The young women of childbearing age are mostly affected by MS. Biological role of women is fullfiled by maternity and their wish to have a child is also common for women with MS. Conception, pregnancy and delivery is immunological action and maternal immune system undergoes great changes. Brestfeeding is greatly important for optimal development of the newborn in the first months after delivery. The hormonal changes during brestfeeding are positively modulating the autoimmune reactivity of MS females and there are strong clinical data that exclusively brestfeeding in the early period is beneficial for babies and mothers. The question is how to manage the immunomodulatory and immunosuppressive treatment during brestfeeding. The treatment potential risks and benefit for babies and mothers benefit is considered. For mothers with high active MS we have to realise their earlier return to DMD treatment to consider neurologic condition and clinical activity. Individual attitude with careful monitoring is for all mothers absolutely necessary.

Keywords: sclerosis multiplex, lactation, brestfeeding, prolactin, immunoreactivity, immunomodulation treatment

Published: March 1, 2019  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Zapletalová O. Multiple sclerosis – maternity and breastfeeding. Neurol. praxi. 2019;20(1):33-36. doi: 10.36290/neu.2019.088.
Download citation

References

  1. Amas S, Vance J, Baker T, Hale T. Management of multiple sclerosis in the breastfeeding mother. Multiple Sclerosis International Volume 2016, article ID6527458,10 pages. Go to original source...
  2. Borba VV, Zandman-Goddard G, Shoenfeld Y. Prolactin and autoimmunity. Front Immunol 2018; 9: 73. Go to original source... Go to PubMed...
  3. Boster AL, Ford CC, Neudorfer O, Gilgun-Sherki Y. Glatiramer acetate: long-term safety and efficacy in relapsing-remitting multiple sclerosis. Expert Rev Neurother 2015; 15: 575-586. Go to original source... Go to PubMed...
  4. Cooper SD, Felkins K, Baker TE, HaleTW. Transfer of methylprednisolone into breast milk in a mother with multiple sclerosis. J.Hum Lact 2015; 31(2): 237-239. Go to original source... Go to PubMed...
  5. Costanza M, Pedotti R. Prolactin: friend or foe in central nervous system autoimmune inflammation? Int J Mol Sci 2016; 17: E2026. Go to original source... Go to PubMed...
  6. Coyle PK. Multiple sclerosis and pregnancy prescriptions. Expert Opin Drug Saf 2014; 13: 1565-1568. Go to original source... Go to PubMed...
  7. De Giglio L, Marinelli F, Prosperini L, Contessa GM, Gurreri F, Piattella MC, De Angelis F, Barletta VT, Tomassini V, Pantano P, Pozzilli C. Relationship between prolactin plasma levels and white matter volume in women with multiple sclerosis. Mediators Inflamm 2015; 2015: 732539. Go to original source... Go to PubMed...
  8. Fabian M. Pregnancy in the setting of multiple sclerosis. Continuum 2016; 22: 837-850. Go to original source... Go to PubMed...
  9. Gregg C, Shikar V, Larsen P, Mak G, Chojnacki A, Yong VW, Weiss S. White matter plasticity and enhanced remyelination in the maternal CNS. J Neurosci 2007; 27: 1812-1823. Go to original source... Go to PubMed...
  10. Hellwig K, Rockhoff M, Herbstritt S, Borisow N, Haghikia A, Elias-Hamp B, Menck S, Gold R, Langer-Gould A. Exclusive breastfeeding and the effect on postpartum multiple sclerosis relapses. JAMA Neurol 2015; 72: 1132-1138. Go to original source... Go to PubMed...
  11. Krejsek J, Andrýs C, Krčmová I. Imunologie člověka. Hradec Králové: Garamon 2016: 495.
  12. Langer-Gould A, Beaber BE. Effects of pregnancy and breastfeeding on the multiple sclerosis disease course. Clin Immunol 2013; 149: 244-250. Go to original source... Go to PubMed...
  13. Langer-Gould A, Smith JB, Hellwig K, Gonzales E, Haraszti S, Koebnick C, Xiang A. Breastfeeding, ovulatory years, and risk of multiple sclerosis. Neurology 2017; 89: 563-569. Go to original source... Go to PubMed...
  14. Lu E, Wang BW, Guimond C, Synnes A, Sadovnick AD, Dahlgren L, Traboulsee A, Tremlett H. Safety of disease - modifying drugs for multiple sclerosis in pregnancy: current challenges and future considerations for effective pharmacovigilance. Expert Rev Neurother 2013; 13: 251-261. Go to original source... Go to PubMed...
  15. Rae-Grant A, Day SG, Marrie RA, Rabinstein A, Cree BA, Gronseth GS, Haboubi M, Halperd J, Hosey JP, Jones DE, Lisak R, Pelletier D, Potrebik S, Sitcov C, Sommers R, Stachowiak J, Getchius T,Shannon A, Merillat, Pringsheim T. Practice guideline recommendations summary: disease-modyffying therapies for adults with sclerosis multiple sclerosis. Neurology 2018;90: 777-788. Go to original source... Go to PubMed...
  16. Ortona E, Pierdominici M, Masseli A, Veroni C, Aloisi F, Shoenfeld Y. Sex-based differences in autoimmune diseases. Ann Ist Super Sanita 2016; 52: 205-212. Go to PubMed...
  17. Shingo T, Gregg C, Enwere E, Fujikawa H, Hassam R, Geary C, Cross JC, Weiss S. Pregnancy-stimulated neurogenesis in the adult female forebrain mediated by prolactin. Science 2003; 299: 117-120. Go to original source... Go to PubMed...
  18. Tang MW, Garcia S, Gerlag DM, Tak PP, Reedquist KA. Insight into the endocrine systém and the immune system: a review of the inflammatory role of prolactin in rheumatoid arthritis ad psoriatic arthritis. Front Immunol 2017; 8: 720. Go to original source... Go to PubMed...
  19. Thöne J, Thiel S, Gold R, Hellwig K. Treatment of multiple sclerosis during pregnancy - safety considerations. Expert Opin Drug Saf 2017; 162: 523-534. Go to original source... Go to PubMed...
  20. Zhornitsky S, Yong VW, Weiss S, Metz LM. Prolactin in multiple sclerosis. Mult Scler 2013; 19: 15-23. Go to original source... Go to PubMed...
  21. Voskuhl R, Momtazee C. Pregnancy: Effect on multiple sclerosis, treatment considerations, and breastfeeding. Neurotherapeutics(2017) 14: 974-984. Go to original source... Go to PubMed...
  22. http://www.olecich.cz/




Neurology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.