{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:29:15Z","timestamp":1790306955415,"version":"4.1.0"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","msard-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis and Related Disorders"],"published-print":{"date-parts":[[2020,8]]},"DOI":"10.1016\/j.msard.2020.102146","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T23:17:37Z","timestamp":1588720657000},"page":"102146","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":35,"special_numbering":"C","title":["Pregnancy outcomes and postpartum relapse rates in women with RRMS treated with alemtuzumab in the phase 2 and 3 clinical development program over 16 years"],"prefix":"10.1016","volume":"43","author":[{"given":"Jiwon","family":"Oh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2020-3126","authenticated-orcid":false,"given":"Anat","family":"Achiron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-6488","authenticated-orcid":false,"given":"Elisabeth G.","family":"Celius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Chambers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Derwenskus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Devonshire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Hellwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George J.","family":"Hutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-8517","authenticated-orcid":false,"given":"Pamela","family":"McCombe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Raphael","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Faria","family":"Simm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen G.","family":"Vincent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Daizadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.\u202fAlastair\u202fS.","family":"Compston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.msard.2020.102146_bib0001","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1097\/01.AOG.0000437385.88715.4a","article-title":"Committee Opinion No 579: Definition of term pregnancy","volume":"122","year":"2013","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.msard.2020.102146_bib0004","series-title":"Foundation, M.o.D.B.D","article-title":"March of Dimes Global Report on Birth Defects","author":"Christianson","year":"2006"},{"key":"10.1016\/j.msard.2020.102146_bib0003","unstructured":"CDC, Update on overall prevalence of major birth defects - Atlanta, Georgia, 1978-2005. https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm5701a2.htm. Accessed March 15, 2019."},{"key":"10.1016\/j.msard.2020.102146_bib0006","unstructured":"Coles, AJ, Arnold, DL, Bass, A, Boster, A, Compston, DAS, Fernandez, O, Kubala Havrdova, E, Nakamura, K, Traboulsee, A, Ziemssen, T, Jacobs, A, Margolin, DH, Huang, X, Daizadeh, N, Chirieac, MC, Selmaj, KW, manuscript in preparation. Efficacy and safety of alemtuzumab over 6 years: final results of the 4-year CARE-MS extension trial."},{"issue":"9856","key":"10.1016\/j.msard.2020.102146_bib0005","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1016\/S0140-6736(12)61769-3","article-title":"Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial","volume":"380","author":"Cohen","year":"2012","journal-title":"Lancet"},{"issue":"2 suppl","key":"10.1016\/j.msard.2020.102146_bib0007","first-page":"P651","article-title":"Long-term efficacy and safety of alemtuzumab in patients with RRMS: 12-year follow-up of the CAMMS223 study","volume":"25","author":"Coles","year":"2019","journal-title":"Mult Scler"},{"issue":"11","key":"10.1016\/j.msard.2020.102146_bib0008","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1212\/WNL.0000000000004354","article-title":"Alemtuzumab CARE-MS II 5-year follow-up: efficacy and safety findings","volume":"89","author":"Coles","year":"2017","journal-title":"Neurology"},{"issue":"17","key":"10.1016\/j.msard.2020.102146_bib0002","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1056\/NEJMoa0802670","article-title":"Alemtuzumab vs. interferon beta-1a in early multiple sclerosis","volume":"359","author":"Coles","year":"2008","journal-title":"N Engl J Med"},{"issue":"9856","key":"10.1016\/j.msard.2020.102146_bib0009","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/S0140-6736(12)61768-1","article-title":"Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial","volume":"380","author":"Coles","year":"2012","journal-title":"Lancet"},{"issue":"2_suppl","key":"10.1016\/j.msard.2020.102146_bib0010","first-page":"P645","article-title":"Alemtuzumab maintains efficacy on clinical and MRI disease activity outcomes, including slowing of brain volume loss, over 9 years in RRMS patients: CARE-MS II follow-up (TOPAZ study)","volume":"25","author":"Comi","year":"2019","journal-title":"Mult Scler"},{"issue":"5","key":"10.1016\/j.msard.2020.102146_bib0011","first-page":"285","article-title":"Rate of pregnancy-related relapse in multiple sclerosis","volume":"339","author":"Confavreux","year":"1998","journal-title":"Pregnancy in Multiple Sclerosis Group. N Engl J Med."},{"issue":"11","key":"10.1016\/j.msard.2020.102146_bib0012","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.1002\/eji.200535075","article-title":"Lymphocyte homeostasis following therapeutic lymphocyte depletion in multiple sclerosis","volume":"35","author":"Cox","year":"2005","journal-title":"Eur J Immunol"},{"issue":"1","key":"10.1016\/j.msard.2020.102146_bib0013","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/1352458518816612","article-title":"Immune thrombocytopenia in alemtuzumab-treated MS patients: incidence, detection, and management","volume":"26","author":"Cuker","year":"2020","journal-title":"Mult Scler"},{"issue":"8","key":"10.1016\/j.msard.2020.102146_bib0014","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1177\/1352458507077896","article-title":"Pregnancy in multiple sclerosis patients treated with immunomodulators prior to or during part of the pregnancy: a descriptive study in the Spanish population","volume":"13","author":"De Las Heras","year":"2007","journal-title":"Mult Scler"},{"issue":"1","key":"10.1016\/j.msard.2020.102146_bib0015","doi-asserted-by":"crossref","first-page":"e194","DOI":"10.1212\/NXI.0000000000000194","article-title":"Alemtuzumab long-term immunologic effect: Treg suppressor function increases up to 24 months","volume":"3","author":"De Mercanti","year":"2016","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"issue":"5","key":"10.1016\/j.msard.2020.102146_bib0016","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1177\/1352458509102366","article-title":"Epidemiological characteristics of pregnancy, delivery, and birth outcome in women with multiple sclerosis in Argentina (EMEMAR study)","volume":"15","author":"Fernandez Liguori","year":"2009","journal-title":"Mult Scler"},{"issue":"2","key":"10.1016\/j.msard.2020.102146_bib0017","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0301-2115(01)00613-3","article-title":"Risk factors in miscarriage: a review","volume":"102","author":"Garcia-Enguidanos","year":"2002","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"6","key":"10.1016\/j.msard.2020.102146_bib0018","doi-asserted-by":"crossref","first-page":"e289","DOI":"10.1212\/NXI.0000000000000289","article-title":"Alemtuzumab treatment alters circulating innate immune cells in multiple sclerosis","volume":"3","author":"Gross","year":"2016","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"issue":"11","key":"10.1016\/j.msard.2020.102146_bib0019","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1212\/WNL.0000000000004313","article-title":"Alemtuzumab CARE-MS I 5-year follow-up: durable efficacy in the absence of continuous MS therapy","volume":"89","author":"Havrdova","year":"2017","journal-title":"Neurology"},{"issue":"17","key":"10.1016\/j.msard.2020.102146_bib0020","doi-asserted-by":"crossref","first-page":"e1570","DOI":"10.1212\/WNL.0000000000006382","article-title":"Relapses and disease-modifying drug treatment in pregnancy and live birth in US women with MS","volume":"91","author":"Houtchens","year":"2018","journal-title":"Neurology"},{"issue":"2","key":"10.1016\/j.msard.2020.102146_bib0021","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/j.1365-2567.2009.03115.x","article-title":"Investigation of the mechanism of action of alemtuzumab in a human CD52 transgenic mouse model","volume":"128","author":"Hu","year":"2009","journal-title":"Immunology"},{"issue":"6","key":"10.1016\/j.msard.2020.102146_bib0022","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1177\/1352458513507816","article-title":"Predictors and dynamics of postpartum relapses in women with multiple sclerosis","volume":"20","author":"Hughes","year":"2014","journal-title":"Mult Scler"},{"issue":"1","key":"10.1016\/j.msard.2020.102146_bib0023","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.ncl.2018.09.007","article-title":"Management of Demyelinating Disorders in Pregnancy","volume":"37","author":"Kaplan","year":"2019","journal-title":"Neurol Clin"},{"issue":"1","key":"10.1016\/j.msard.2020.102146_bib0024","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1186\/s12974-018-1334-y","article-title":"Restoration of regulatory B cell deficiency following alemtuzumab therapy in patients with relapsing multiple sclerosis","volume":"15","author":"Kim","year":"2018","journal-title":"J Neuroinflammation"},{"issue":"15 suppl","key":"10.1016\/j.msard.2020.102146_bib0025","article-title":"Pregnancy-related relapses in a large, contemporary multiple sclerosis cohort: no increased risk in the postpartum period","volume":"92","author":"Langer-Gould","year":"2019","journal-title":"Neurology."},{"key":"10.1016\/j.msard.2020.102146_bib0026","unstructured":"LEMTRADA (alemtuzumab) [Prescribing Information]. Genzyme Corporation, USA."},{"key":"10.1016\/j.msard.2020.102146_bib0027","unstructured":"LEMTRADA [Summary of Product Characteristics], April 2019. Sanofi Belgium, Diegem, Belgium."},{"issue":"3","key":"10.1016\/j.msard.2020.102146_bib0028","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/cei.13208","article-title":"Clinical pharmacology of alemtuzumab, an anti-CD52 immunomodulator, in multiple sclerosis","volume":"194","author":"Li","year":"2018","journal-title":"Clin Exp Immunol"},{"issue":"6","key":"10.1016\/j.msard.2020.102146_bib0029","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1097\/AOG.0000000000001152","article-title":"Trends in Stillbirth by Gestational Age in the United States, 2006-2012","volume":"126","author":"MacDorman","year":"2015","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.msard.2020.102146_bib0030","series-title":"21st World Congress of Neurology","article-title":"Alemtuzumab treatment has no adverse impact on sperm quality, quantity, or motility: a CARE-MS substudy","author":"Margolin","year":"2013"},{"issue":"1 suppl","key":"10.1016\/j.msard.2020.102146_bib0031","first-page":"P842","article-title":"Pregnancy outcomes in the alemtuzumab multiple sclerosis clinical development program","volume":"20","author":"McCombe","year":"2014","journal-title":"Mult Scler"},{"issue":"7","key":"10.1016\/j.msard.2020.102146_bib0032","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1177\/1352458517731913","article-title":"Recurrence of disease activity during pregnancy after cessation of fingolimod in multiple sclerosis","volume":"24","author":"Meinl","year":"2018","journal-title":"Mult Scler"},{"issue":"2 suppl","key":"10.1016\/j.msard.2020.102146_bib0033","first-page":"P974","article-title":"Alemtuzumab maintains efficacy on clinical and MRI disease activity outcomes, including slowing of brain volume loss, over 9 years in RRMS patients: CARE-MS I follow-up (TOPAZ study)","volume":"25","author":"Montalban","year":"2019","journal-title":"Mult Scler"},{"issue":"2","key":"10.1016\/j.msard.2020.102146_bib0034","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1177\/1352458517751049","article-title":"ECTRIMS\/EAN Guideline on the pharmacological treatment of people with multiple sclerosis","volume":"24","author":"Montalban","year":"2018","journal-title":"Mult Scler"},{"key":"10.1016\/j.msard.2020.102146_bib0035","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.msard.2019.01.003","article-title":"Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: a contemporary cohort study","volume":"28","author":"Nguyen","year":"2019","journal-title":"Mult Scler Relat Disord"},{"issue":"7251","key":"10.1016\/j.msard.2020.102146_bib0036","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1136\/bmj.320.7251.1708","article-title":"Maternal age and fetal loss: population based register linkage study","volume":"320","author":"Nybo Andersen","year":"2000","journal-title":"BMJ"},{"issue":"12","key":"10.1016\/j.msard.2020.102146_bib0037","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1002\/bdra.20735","article-title":"Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004-2006","volume":"88","author":"Parker","year":"2010","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"issue":"9","key":"10.1016\/j.msard.2020.102146_bib0038","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1177\/1352458519841829","article-title":"Incidence, management, and outcomes of autoimmune nephropathies following alemtuzumab treatment in patients with multiple sclerosis","volume":"25","author":"Phelps","year":"2019","journal-title":"Mult Scler"},{"issue":"6","key":"10.1016\/j.msard.2020.102146_bib0039","doi-asserted-by":"crossref","first-page":"e39416","DOI":"10.1371\/journal.pone.0039416","article-title":"Human peripheral blood mononuclear cells exhibit heterogeneous CD52 expression levels and show differential sensitivity to alemtuzumab mediated cytolysis","volume":"7","author":"Rao","year":"2012","journal-title":"PLoS One"},{"issue":"10","key":"10.1016\/j.msard.2020.102146_bib0040","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1136\/jnnp.56.10.1062","article-title":"Pregnancy and multiple sclerosis: a longitudinal study of 125 remittent patients","volume":"56","author":"Roullet","year":"1993","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"12","key":"10.1016\/j.msard.2020.102146_bib0041","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1136\/jnnp-2016-314013","article-title":"Higher latitude is significantly associated with an earlier age of disease onset in multiple sclerosis","volume":"87","author":"Tao","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"7","key":"10.1016\/j.msard.2020.102146_bib0042","first-page":"1","article-title":"Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990-2008","volume":"60","author":"Ventura","year":"2012","journal-title":"Natl Vital Stat Rep"},{"issue":"7","key":"10.1016\/j.msard.2020.102146_bib0043","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1177\/1352458514554056","article-title":"Natalizumab for the prevention of post-partum relapses in women with multiple sclerosis","volume":"21","author":"Vukusic","year":"2015","journal-title":"Mult Scler"},{"key":"10.1016\/j.msard.2020.102146_bib0044","unstructured":"WHO, 2006. Child growth standards. https:\/\/www.who.int\/childgrowth\/standards\/Technical_report.pdf. (Accessed January 6, 2020)."},{"key":"10.1016\/j.msard.2020.102146_bib0045","article-title":"Infection risk with alemtuzumab decreases over time: pooled analysis of 6-year data from the CAMMS223, CARE-MS I, and CARE-MS II studies and the CAMMS03409 extension study","author":"Wray","year":"2018","journal-title":"Mult Scler,"},{"issue":"6","key":"10.1016\/j.msard.2020.102146_bib0046","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1136\/jech-2015-207013","article-title":"Declines in stillbirth and neonatal mortality rates in Europe between 2004 and 2010: results from the Euro-Peristat project","volume":"70","author":"Zeitlin","year":"2016","journal-title":"J Epidemiol Community Health"},{"issue":"12","key":"10.1016\/j.msard.2020.102146_bib0047","doi-asserted-by":"crossref","first-page":"5867","DOI":"10.4049\/jimmunol.1301926","article-title":"Differential reconstitution of T cell subsets following immunodepleting treatment with alemtuzumab (anti-CD52 monoclonal antibody) in patients with relapsing-remitting multiple sclerosis","volume":"191","author":"Zhang","year":"2013","journal-title":"J Immunol"}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034820302224?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034820302224?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:50:18Z","timestamp":1761900618000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211034820302224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":47,"alternative-id":["S2211034820302224"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2020.102146","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pregnancy outcomes and postpartum relapse rates in women with RRMS treated with alemtuzumab in the phase 2 and 3 clinical development program over 16 years","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2020.102146","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"102146"}}