{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T04:10:54Z","timestamp":1778299854460,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    There is a paucity of data regarding the effects of prenatal disease\u2010modifying therapies (DMTs) for multiple sclerosis (MS), on congenital anomalies in the offspring. Moreover, data on the association with neurodevelopmental disorders are lacking. This is an historical cohort study, within the Israeli Clalit Health Services database (2005\u20132024) that included all children, born to mothers carrying a diagnosis of MS. Mothers' demographic and clinical characteristics were used to account for potential confounders. A marginal model used for the association between prenatal dispensed DMTs and neurodevelopmental disorders. A log\u2010binomial regression model used to estimate relative risks (RR), 95% CI for the association between exposure and major congenital anomalies (MCAs). The cohort included 1374 children: 484 exposed prenatally to DMTs (237, 85, 56, 49, 25, 32 exposed to interferon\u2010\u03b2, glatiramer, monoclonal antibodies, fumarates, sphingosine\u20101\u2010phosphate receptor (S1PR) modulators, or a combination of therapies, respectively). In a mean follow\u2010up of 7.5\u2009years (maximum 19.8\u2009years), prenatal exposure to DMTs was not associated with significant risk for neurodevelopmental disorders, in univariate and in multivariate models. Within 1252 children with 2\u2009years of follow\u2010up, 50 (3.9%) children were identified with MCAs. There was higher rate of MCAs among S1PR modulator\u2010exposed children 2(8%). Due to the small group risk estimates for S1PR modulators had wide CIs, with RR\u2009=\u20092.0 (95% CI 0.51\u20138.1,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.314); RR\u2009=\u20095.16 (95% CI 1.47\u201318.2,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.011) in the univariate and sensitivity analysis, respectively. In conclusion, in the current cohort, prenatal exposure to DMTs was not associated with neurodevelopmental disorders. Exposure to S1PR modulators in pregnancy was associated with higher risk for congenital anomalies. Prospective larger studies are warranted.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70235","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T06:54:46Z","timestamp":1771570486000},"page":"1565-1573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Neurodevelopmental Disorders and Congenital Anomalies With Prenatal Multiple Sclerosis Treatment\u2014Real\u2010World Historical Cohort Study"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-4320","authenticated-orcid":false,"given":"Bar","family":"Rosh","sequence":"first","affiliation":[{"name":"Obstetrics &amp; Gynecology Division Rambam Medical Center  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5521-2571","authenticated-orcid":false,"given":"Ofek","family":"Levi","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7602-7363","authenticated-orcid":false,"given":"Nili","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8686-2431","authenticated-orcid":false,"given":"Amir","family":"Yahav","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4369-6813","authenticated-orcid":false,"given":"Naomi","family":"Gronich","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00426-4"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000453"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000913"},{"key":"e_1_2_10_4_1","article-title":"Maternal multiple sclerosis is not a risk factor for neurodevelopmental disorders in offspring","volume":"7","author":"Carta A.","year":"2021","journal-title":"Mult. 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