Balancing Medication With Pregnancy

Glatiramer acetate treatment for multiple sclerosis is safe during pregnancy

(RxWiki News) When diseases occur during childbearing years, it’s not always possible to stop treatment for the disease. Doctors and patients must balance the concern for the drug's possible effects on pregnancy with the concern for disease relapse.

A recent study looked at the effects of glatiramer acetate (GA), a drug used to control multiple sclerosis (MS), during pregnancy, particularly with regards to miscarriage.

The study found that GA early exposure during pregnancy was not associated with any increased risk. The chance of miscarriage within patients taking GA was 17 percent, a rate similar to the general population.

"Speak to your doctor if you are trying to conceive."

Marta Giannini, PhD, of the University of Florence and colleagues examined 415 pregnant mothers with MS in 21 Italian MS centers. Study participants were divided into two categories, those whose babies had been exposed to GA and those whose had not.

The study participants received a medical follow-up every six months and in the case of relapse. Within the first six months, each mother in the study was interviewed on their pregnancy and any difficulties they experienced.

Factors such as miscarriage, weight and length of the baby, premature birth and cesarean delivery were compared between the two groups. Mother’s age, educational level, MS disease duration, disability, previous pregnancies or miscarriages, substance exposure, gestational age, delivery method and gender of the baby were also considered.

Study participants and their children were followed for about two years.

The 415 women had a total of 423 pregnancies. Seventeen of those pregnancies were exposed to GA, 88 were exposed to interferon beta (IFNB), another common drug used to treat MS, and 318 were not exposed to an MS drug.

Sixteen out of 17 pregnancies with exposure to GA resulted in live birth. Within the IFNB group, 75 live births occurred and 295 live births were completed within the group not exposed to MS drug.

This data does not represent an increased risk of miscarriage for any group in the study. Early delivery, birth weight and length were also not affected by GA exposure.

No complications or abnormalities were associated with GA exposure.

Lower birth weight and length was associated with IFNB exposure. This is thought to be from a cytokine imbalance.

These results are a relief to those with high MS disease activity that are planning a pregnancy. Stopping GA medication may be unnecessary.

It remains absolutely critical for all women who have become pregnant or are planning on becoming pregnant to speak to her doctor immediately about which medications she should take or avoid. Some women will need to continue taking regular prescriptions, while others may have to stop for the safety of the baby. 

The study was published in BioMed Central Neurology.

The authors collectively report associations with over half a dozen pharmaceutical companies. In addition, authors report connections to medical publications and educational groups.

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Review Date: 
December 3, 2012