Document Type : Original Article
Authors
1 Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya Department of Medicine, School of Medicine, University of Benghazi, Benghazi, Libya
2 Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya
Abstract
Background: Misconceptions about multiple sclerosis (MS), pregnancy, and disease-modifying therapies (DMTs) are common, often driven by fears that DMTs pose risks to the fetus or that pregnancy will exacerbate the disease. This study aimed to evaluate and document local clinical practices and decision-making processes in the management of women with MS regarding DMT use during pregnancy.
Methods: A retrospective review was conducted at the MS Clinic of Benghazi Medical Center, Benghazi, Libya, from January 1, 2016 to December 31, 2019. Medical records of women meeting the 2017 McDonald’s criteria for MS diagnosis were analyzed. Data collected included demographic and clinical variables, pregnancy outcomes, DMT use, and postpartum care. Statistical analysis was performed using SPSS software.
Results: Thirty-six women (61 pregnancies) were included. The median age was 36 years (range: 24-56). Unplanned pregnancies occurred in 24/36 women, 32/61 pregnancies (52%). Only five women continued DMTs during pregnancy. Uncomplicated pregnancies occurred in 30/36 women (83%), while postpartum relapses were reported in 12 women (33%), 11 with unplanned pregnancies. The median time to DMT resumption postpartum was 4 months. Breastfeeding was practiced for a median duration of 4 months. Preconception magnetic resonance imaging (MRI) was performed in 6 women (16.6%).
Conclusion: This study provides valuable insights into the management of MS during pregnancy in Libya. While the sample size is small, the findings underscore the importance of standardized guidelines for DMT use, pregnancy planning, and postpartum care. Future studies with larger cohorts and broader DMT options are needed.
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