Contributions
Abstract: P358
Type: Poster
Abstract Category: Clinical aspects of MS - 6 MS and gender
Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system that commonly affects young women. Consequently, issues related to family planning are of critical importance. The safety of most MS disease modifying therapies are not fully known during pregnancy, making pregnancy planning important.
Methods: A retrospective observational cohort study was conducted with the Cleveland Clinic (CC) Mellen Center clinical population, after IRB approval. Subjects with co-existing diagnoses of pregnancy and MS were identified using an automated data pull. Next, a chart review was conducted to identify study measures. Patients were grouped based on whether their pregnancies were planned or unplanned. Stepwise logistic regression was used with analysis of variance (ANOVA). Bonferroni correction was used to determine significance of risk factors for unplanned pregnancies.
Results: 150 pregnancies in MS patients were identified. After a chart review 45 patients were identified who had both obstetric and MS care within the CC hospital system. There were 63 pregnancies (20 unplanned and 43 planned). The ratio of unplanned pregnancy was 32%. Risk factors for unplanned pregnancy were younger age (p-value < 0.01), being on DMT (p-value < 0.001), being unmarried (p-value < 0.001), being primigravida (p-value< 0.01), and lacking family planning counselling (p-value< 0.001).
Conclusion: This study suggests that risk factors for unplanned pregnancies are the same for the general and MS populations. Prior to this study, the ratio of unplanned pregnancy had been assumed to be 50%. This decrease ratio of unplanned pregnancies in this cohort may due to a higher level of care or socioeconomic factors that were missed in this chart review. Regardless of the ratio, this study highlights the importance of provider-initiated family planning education and the importance of discussing family planning issues with MS patients. Planning pregnancies, particularly in young patients, may minimize in-utero drug exposure.
Disclosure:
Andrew Smith: received personal compensation for serving as a consultant or speaker from Genzyme,
Dr. Ontaneda: has received personal compensation for consulting with Genentech, Biogen Idec. Research Support from Genzyme and Novartis.
Dr. Cohen: received personal compensation for serving as a consultant or speaker from Merck, Novartis, and Receptos. Editor of Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Dr. Rensel: serves as a consultant or speaker for Biogen, Teva, Genzyme and Novartis. She receives grant funding from NMSS.
Abstract: P358
Type: Poster
Abstract Category: Clinical aspects of MS - 6 MS and gender
Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system that commonly affects young women. Consequently, issues related to family planning are of critical importance. The safety of most MS disease modifying therapies are not fully known during pregnancy, making pregnancy planning important.
Methods: A retrospective observational cohort study was conducted with the Cleveland Clinic (CC) Mellen Center clinical population, after IRB approval. Subjects with co-existing diagnoses of pregnancy and MS were identified using an automated data pull. Next, a chart review was conducted to identify study measures. Patients were grouped based on whether their pregnancies were planned or unplanned. Stepwise logistic regression was used with analysis of variance (ANOVA). Bonferroni correction was used to determine significance of risk factors for unplanned pregnancies.
Results: 150 pregnancies in MS patients were identified. After a chart review 45 patients were identified who had both obstetric and MS care within the CC hospital system. There were 63 pregnancies (20 unplanned and 43 planned). The ratio of unplanned pregnancy was 32%. Risk factors for unplanned pregnancy were younger age (p-value < 0.01), being on DMT (p-value < 0.001), being unmarried (p-value < 0.001), being primigravida (p-value< 0.01), and lacking family planning counselling (p-value< 0.001).
Conclusion: This study suggests that risk factors for unplanned pregnancies are the same for the general and MS populations. Prior to this study, the ratio of unplanned pregnancy had been assumed to be 50%. This decrease ratio of unplanned pregnancies in this cohort may due to a higher level of care or socioeconomic factors that were missed in this chart review. Regardless of the ratio, this study highlights the importance of provider-initiated family planning education and the importance of discussing family planning issues with MS patients. Planning pregnancies, particularly in young patients, may minimize in-utero drug exposure.
Disclosure:
Andrew Smith: received personal compensation for serving as a consultant or speaker from Genzyme,
Dr. Ontaneda: has received personal compensation for consulting with Genentech, Biogen Idec. Research Support from Genzyme and Novartis.
Dr. Cohen: received personal compensation for serving as a consultant or speaker from Merck, Novartis, and Receptos. Editor of Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Dr. Rensel: serves as a consultant or speaker for Biogen, Teva, Genzyme and Novartis. She receives grant funding from NMSS.