Abstract: EP1370
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS and gender
Introduction: Since 2010, we've recommended patients in childbearing age to discontinue glatiramer acetate (GA) or interferon (IFN) only after confirmed pregnancy (Pg), avoiding wash-out periods or disease activity while they desire to become Pg. Real world information about perinatal outcomes are needed.
Objective: To explore the effect of exposure to GA or IFN on Pg outcomes in Chilean patients.
Methods: A retrospective cohort of patients controlled in the Programa de Esclerosis Múltiple UC between 2010-2018 was carried out. The outcomes of women exposed to GA or IFN during Pg were compared with the registry of the anthropometric growth curves of Chilean newborns. Data was collected from clinical records and a standardized telephonic questionnaire was also performed.
Results: By May 2018, from a total of 663 MS patients, 433 women, 215 were exposed to GA and IFN. From this sample, we only found 26 Pg from patients effectively receiving treatment with GA (n=8) or IFN (n=18) by the time of conception. During Pg, none of the patients presented with relapses. There were 12 vaginal births, 7 elective c-sections, and 4 emergency c-sections (2 placental abruption, 1 failed forceps and 1 failed induction). One patient required in-vitro fertilization. One first trimester spontaneous abortion (IFN), one ectopic Pg (IFN), and one ongoing Pg were also observed. There were 5 preterm newborns, two at 36w, two at 32w (twins), and one at 25w. Mean gestational age was 37±3.4w (median 38, range 25-40). When comparing weight and height according to gestational age, mean values were within the estimate for the Chilean population with a confidence interval of 95%; at 37w 3340±640g, size 49.25±1.3cm, at 38w weight 3272±471g, size 49.3±1.3cm, and at 39w weight 3164±159g, size 49.5±0.8cm; 3 newborns were outside the range, 1 small for gestational age (40cm, 36w), 1 overweight (3980g, 37w) and 1 with low birth weight (2570g, 38w). Mean exclusive breastfeeding time was 4.5±2.9 months. During breastfeeding, 3 patients had a relapse, at 3rd (brainstem), 5th (myelitis), and 7th (optic neuritis) months, suspending breastfeeding and re-starting DMT. By the time of this analysis, no congenital malformations were reported.
Conclusions: Pg outcomes from patients who discontinued GA or IFN only after confirmed Pg seem comparable to epidemiological data of Chilean newborns, with no congenital malformations reported to date, supporting the safety of continuing GA of IFN until confirmed Pg.
Disclosure: Bernardita Soler nothing to disclose
Ethel Ciampi nothing to disclose
Reinaldo Uribe nothing to disclose
Elizabeth Vergara nothing to disclose
Ana Reyes nothing to disclose
Claudia Cárcamo nothing to disclose
Abstract: EP1370
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - MS and gender
Introduction: Since 2010, we've recommended patients in childbearing age to discontinue glatiramer acetate (GA) or interferon (IFN) only after confirmed pregnancy (Pg), avoiding wash-out periods or disease activity while they desire to become Pg. Real world information about perinatal outcomes are needed.
Objective: To explore the effect of exposure to GA or IFN on Pg outcomes in Chilean patients.
Methods: A retrospective cohort of patients controlled in the Programa de Esclerosis Múltiple UC between 2010-2018 was carried out. The outcomes of women exposed to GA or IFN during Pg were compared with the registry of the anthropometric growth curves of Chilean newborns. Data was collected from clinical records and a standardized telephonic questionnaire was also performed.
Results: By May 2018, from a total of 663 MS patients, 433 women, 215 were exposed to GA and IFN. From this sample, we only found 26 Pg from patients effectively receiving treatment with GA (n=8) or IFN (n=18) by the time of conception. During Pg, none of the patients presented with relapses. There were 12 vaginal births, 7 elective c-sections, and 4 emergency c-sections (2 placental abruption, 1 failed forceps and 1 failed induction). One patient required in-vitro fertilization. One first trimester spontaneous abortion (IFN), one ectopic Pg (IFN), and one ongoing Pg were also observed. There were 5 preterm newborns, two at 36w, two at 32w (twins), and one at 25w. Mean gestational age was 37±3.4w (median 38, range 25-40). When comparing weight and height according to gestational age, mean values were within the estimate for the Chilean population with a confidence interval of 95%; at 37w 3340±640g, size 49.25±1.3cm, at 38w weight 3272±471g, size 49.3±1.3cm, and at 39w weight 3164±159g, size 49.5±0.8cm; 3 newborns were outside the range, 1 small for gestational age (40cm, 36w), 1 overweight (3980g, 37w) and 1 with low birth weight (2570g, 38w). Mean exclusive breastfeeding time was 4.5±2.9 months. During breastfeeding, 3 patients had a relapse, at 3rd (brainstem), 5th (myelitis), and 7th (optic neuritis) months, suspending breastfeeding and re-starting DMT. By the time of this analysis, no congenital malformations were reported.
Conclusions: Pg outcomes from patients who discontinued GA or IFN only after confirmed Pg seem comparable to epidemiological data of Chilean newborns, with no congenital malformations reported to date, supporting the safety of continuing GA of IFN until confirmed Pg.
Disclosure: Bernardita Soler nothing to disclose
Ethel Ciampi nothing to disclose
Reinaldo Uribe nothing to disclose
Elizabeth Vergara nothing to disclose
Ana Reyes nothing to disclose
Claudia Cárcamo nothing to disclose