Show simple item record

dc.contributor.authorDobson, Ren_US
dc.contributor.authorJokubaitis, VGen_US
dc.contributor.authorGiovannoni, Gen_US
dc.date.accessioned2020-06-09T15:25:36Z
dc.date.available2020-05-25en_US
dc.date.issued2020-05-30en_US
dc.identifier.urihttps://qmro.qmul.ac.uk/xmlui/handle/123456789/64764
dc.description.abstractBACKGROUND: Women with MS are advised that relapse rates fall during pregnancy and rebound post-partum. This advice originates from 1998; smaller, more recent, studies have not been previously pooled. METHODS: All studies published since 1998 providing raw relapse data were considered for inclusion. Single arm meta-analysis was performed using a restricted maximum likelihood random effects model with inverse variance; secondary subgroup analysis and meta regression were then performed. Annualised relapse rates (ARR), or relapse numbers/rates suitable for conversion into ARR during pregnancy and the post-partum period were included. Secondary subgroup analysis examined year of data collection, DMT exposure, breastfeeding and data source. RESULTS: 7034 pregnancies from 6430 women were included. ARR fell from 0.57 (95%CI 0.45-0.70) pre-pregnancy to 0.36 (0.28-0.44), 0.29 (0.21-0.36) and 0.16 (0.11-0.21) during trimesters 1,2, and 3, with a post-partum rebound (ARR 0.85, 95%CI 0.70-1.00). ARR reduced pre-pregnancy and post-partum over time (p<0.001). Relapse rates were lower in claims databases than elsewhere. CONCLUSIONS: Despite high heterogeneity, we confirm the historic assumption that ARR reduces during pregnancy, and demonstrate an overall reduction in ARR over time. Studies using data originating from claims databases demonstrated a lower relapse rate at all time points, which has not previously been demonstrated.en_US
dc.format.extent102241 - ?en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofMult Scler Relat Disorden_US
dc.rights© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectMultiple sclerosisen_US
dc.subjectbreast feedingen_US
dc.subjectdisease modifying therapyen_US
dc.subjectpregnancyen_US
dc.subjectrelapseen_US
dc.titleChange in pregnancy-associated multiple sclerosis relapse rates over time: a meta-analysis.en_US
dc.typeArticle
dc.identifier.doi10.1016/j.msard.2020.102241en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/32521483en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
pubs.volume44en_US
dcterms.dateAccepted2020-05-24en_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.funder.project483cf8e1-88a1-4b8b-aecb-8402672d45f8en_US


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record