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Reproductive decision-making in women with multiple sclerosis in the New York State Multiple Sclerosis Consortium
Author(s): ,
K. Kavak
Affiliations:
New York State Multiple Sclerosis Consortium, Buffalo, NY, United States
,
C. Vaughn
Affiliations:
New York State Multiple Sclerosis Consortium, Buffalo, NY, United States
,
B. Teter
Affiliations:
New York State Multiple Sclerosis Consortium, Buffalo, NY, United States
,
K. Zakalik
Affiliations:
New York State Multiple Sclerosis Consortium, Buffalo, NY, United States
B. Weinstock-Guttman
Affiliations:
New York State Multiple Sclerosis Consortium, Buffalo, NY, United States
ECTRIMS Online Library. Vaughn C. Oct 12, 2018; 228852
Caila Vaughn
Caila Vaughn
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Abstract
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Abstract: P1010

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - MS and gender

Background: Research has shown that a large proportion of women with multiple sclerosis (MS) who chose not to become pregnant after being diagnosed made that choice because of MS. In the past, women with MS were counselled against pregnancy; however, recent studies have documented that pregnancy itself poses no increased risk to a woman with MS and that the MS diagnosis poses no increased risk to a fetus.
Objective: To investigate factors influencing pregnancy decision-making in women with MS.
Methods: A detailed reproductive questionnaire was distributed to women enrolled in the New York State Multiple Sclerosis Consortium (NYSMSC) from 2012 to 2017. In total, 1,651 women with MS were queried about their reproductive history and reproductive decision-making. Six hundred thirty-five (635) women agreed to participate (38.4% response rate) and completed the questionnaire. Frequencies and percentages were computed for categorical variables and means/medians and standard deviations were computed for continuous variables.
Results: The average age of respondents was 51.3 (SD=11.6) years, and the majority were Caucasian (n=545, 94.3%) with at least a college education (n=420, 76.1%). Out of the 627 subjects with available pregnancy information data, 490 (78.1%) reported a pregnancy. There were 137 women who did not become pregnant. The main reasons were: (1) attempted, but unable (n=33, 22.9%), (2) didn't want children (n=32, 22.2%), (3) not having a spouse or partner (n=23, 16.0%), (4) because of their MS diagnosis (n=22, 15.3%), (5) because of medical condition (n=15, 10.4%), and (6) plan to, but not yet (n=16, 11.1%).
Conclusion: Given that approximately 15% of subjects in our study without a pregnancy indicated they did not want to become pregnant because of MS, it is important for clinicians to ask women of childbearing age about family planning and to have accurate, updated information to provide. The nature of this retrospective analysis means that participants were diagnosed in different cohorts; however, there were no significant differences, between historical and recent cohorts, in the proportion of women who reported not wanting to become pregnant specifically because of MS. Family planning should be an integral part of comprehensive management of MS. Because MS is typically diagnosed during a woman's childbearing years it is important for clinicians to counsel patients about their reproductive decisions and more education is necessary.
Disclosure: Katelyn S. Kavak and Karen L. Zakalik have nothing to disclose.
Caila B Vaughn has served as a consultant for Merck/EMD Serono.
Bianca Weinstock-Guttman has received honoraria as a speaker and as a consultant for Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme & Sanofi, Novarties and Acorda. Dr. Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme & Sanofi , Novartis and Acorda.
Barbara E Teter has received grant and/or research support from Biogen Idec, Teva Neuroscience, EMD Serono, Avanir, Genzyme and Novartis.
This study was sponsored by Teva Pharmaceutical Industries.

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