RESUMEN
BACKGROUND: The course of multiple sclerosis (MS) is influenced by sex, pregnancy and hormonal factors. AIMS: To analyse the influence of the above factors in order to clarify the aetiopathogenic mechanisms involved in the disease. METHODS: We conducted a comprehensive review of scientific publications in the PubMed database using a keyword search for 'multiple sclerosis', 'MS', 'EAE', 'pregnancy', 'hormonal factors', 'treatment', and related terms. We reviewed the advances presented at the meeting held by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in March 2013 in London, as well as recommendations by international experts. RESULTS AND CONCLUSIONS: We provide recommendations for counselling and treating women with MS prior to and during pregnancy and after delivery. Current findings on the effects of treatment on the mother, fetus, and newborn are also presented. We issue recommendations for future research in order to address knowledge gaps and clarify any inconsistencies in currently available data.
Asunto(s)
Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/terapia , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/terapia , Femenino , Humanos , Recién Nacido , Periodo Posparto , Embarazo , Salud de la MujerRESUMEN
Antecedentes: La esclerosis múltiple (EM) es una enfermedad en cuyo curso influyen el género, los factores hormonales y el embarazo. Objetivos: Realizar un análisis de la influencia de esos factores para aportar información sobre los mecanismos etiopatogénicos involucrados en la enfermedad. Métodos: Revisión exhaustiva de publicaciones científicas (búsqueda en la base de datos PubMed utilizando los términos: esclerosis múltiple, EM, EAE, embarazo, factores hormonales, tratamiento y términos relacionados), de los avances presentados en una reunión organizada por el Comité Europeo para el Tratamiento e Investigación de Esclerosis Múltiple (ECTRIMS), celebrado en marzo de 2013 en Londres, así como de las recomendaciones de reconocidos expertos internacionales. Resultados y conclusiones: Se ofrecen recomendaciones para el asesoramiento y la gestión de personas con EM antes de la concepción, durante el embarazo y después del parto. Se comentan también los conocimientos actuales sobre el efecto del tratamiento en la madre, el feto y el recién nacido. Realizamos recomendaciones para investigaciones futuras a fin de subsanar deficiencias de conocimiento y aclarar incoherencias de los datos actualmente disponibles
Background: The course of multiple sclerosis (MS) is influenced by sex, pregnancy and hormonal factors. Aims: To analyse the influence of the above factors in order to clarify the aetiopathogenic mechanisms involved in the disease. Methods: We conducted a comprehensive review of scientific publications in the PubMed database using a keyword search for 'multiple sclerosis', 'MS', 'EAE', 'pregnancy', 'hormonal factors', 'treatment', and related terms. We reviewed the advances presented at the meeting held by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in March 2013 in London, as well as recommendations by international experts. Results and conclusions: We provide recommendations for counselling and treating women with MS prior to and during pregnancy and after delivery. Current findings on the effects of treatment on the mother, fetus, and newborn are also presented. We issue recommendations for future research in order to address knowledge gaps and clarify any inconsistencies in currently available data