{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:33:35Z","timestamp":1791923615759,"version":"4.3.4"},"reference-count":83,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"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":[[2025,10]]},"DOI":"10.1016\/j.msard.2025.106643","type":"journal-article","created":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T05:27:48Z","timestamp":1753594068000},"page":"106643","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"special_numbering":"C","title":["Pregnancy and Multiple Sclerosis: A Narrative Review of Clinical Outcomes, Disease Activity, and Treatment Considerations"],"prefix":"10.1016","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6293-3429","authenticated-orcid":false,"given":"Diego F.","family":"Wyszynski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"9","key":"10.1016\/j.msard.2025.106643_bib0074","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s00415-004-0495-z","article-title":"Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis","volume":"251","author":"Achiron","year":"2004","journal-title":"J. Neurol"},{"issue":"199","key":"10.1016\/j.msard.2025.106643_bib0030","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/ane.12433","article-title":"Hormonal and gender-related immune changes in multiple sclerosis","volume":"132","author":"Airas","year":"2015","journal-title":"Acta. Neurol. Scand"},{"key":"10.1016\/j.msard.2025.106643_bib0022","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.msard.2019.06.007","article-title":"Risk of relapses during pregnancy among multiple sclerosis patients","volume":"34","author":"Alroughani","year":"2019","journal-title":"Mult. Scler. Relat. Disord"},{"issue":"20","key":"10.1016\/j.msard.2025.106643_bib0049","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1212\/WNL.0b013e3181fd62bb","article-title":"Pregnancy and fetal outcomes after interferon-\u03b2 exposure in multiple sclerosis","volume":"75","author":"Amato","year":"2010","journal-title":"Neurology"},{"issue":"9","key":"10.1016\/j.msard.2025.106643_bib0041","doi-asserted-by":"crossref","first-page":"e1152","DOI":"10.1016\/S2214-109X(20)30315-6","article-title":"Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019","volume":"8","author":"Bearak","year":"2020","journal-title":"Lancet Glob. Health"},{"issue":"12","key":"10.1016\/j.msard.2025.106643_bib0010","doi-asserted-by":"crossref","first-page":"581","DOI":"10.17992\/lbl.2020.12.612","article-title":"[Multiple sclerosis and childbirth: relapse frequency and pregnancy outcome. A hospital-based retrospective study]","volume":"106","author":"Bergthorsd\u00f3ttir","year":"2020","journal-title":"Laeknabladid"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0076","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ijgo.2016.01.008","article-title":"The effect of postpartum intravenous immunoglobulins on the relapse rate among patients with multiple sclerosis","volume":"134","author":"Brandt-Wouters","year":"2016","journal-title":"Int. J. Gynaecol. Obstet"},{"key":"10.1016\/j.msard.2025.106643_bib0009","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/513160","article-title":"Multiple sclerosis and pregnancy: current considerations","volume":"2014","author":"Buraga","year":"2014","journal-title":"ScientificWorldJournal"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0070","doi-asserted-by":"crossref","first-page":"243","DOI":"10.2214\/ajr.182.1.1820243","article-title":"Fetal MRI: a developing technique for the developing patient","volume":"182","author":"Coakley","year":"2004","journal-title":"AJR Am. J. Roentgenol"},{"issue":"9648","key":"10.1016\/j.msard.2025.106643_bib0001","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/S0140-6736(08)61620-7","article-title":"Multiple sclerosis","volume":"372","author":"Compston","year":"2008","journal-title":"Lancet"},{"issue":"5","key":"10.1016\/j.msard.2025.106643_bib0021","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1056\/NEJM199807303390501","article-title":"Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple sclerosis group","volume":"339","author":"Confavreux","year":"1998","journal-title":"N. Engl. J. Med"},{"issue":"3","key":"10.1016\/j.msard.2025.106643_bib0027","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/1756285616631897","article-title":"Management of women with multiple sclerosis through pregnancy and after childbirth","volume":"9","author":"Coyle","year":"2016","journal-title":"Ther. Adv. Neurol. Disord"},{"issue":"8","key":"10.1016\/j.msard.2025.106643_bib0003","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1212\/WNL.0000000000012323","article-title":"Secondary progressive Multiple sclerosis: new insights","volume":"97","author":"Cree","year":"2021","journal-title":"Neurology"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0016","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.nrl.2014.12.015","article-title":"Multiple sclerosis and pregnancy: a single-centre prospective comparative study","volume":"32","author":"Cuello","year":"2017","journal-title":"Neurologia"},{"issue":"5","key":"10.1016\/j.msard.2025.106643_bib0036","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s00415-011-6267-7","article-title":"Menarche, oral contraceptives, pregnancy and progression of disability in relapsing onset and progressive onset multiple sclerosis","volume":"259","author":"D'Hooghe","year":"2012","journal-title":"J. Neurol"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0063","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1042\/CS20140095","article-title":"Autologous haematopoietic stem cell transplantation reduces abnormalities in the expression of immune genes in multiple sclerosis","volume":"128","author":"de Paula","year":"2015","journal-title":"Clin. Sci. (Lond)"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0042","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1136\/practneurol-2018-002060","article-title":"UK consensus on pregnancy in multiple sclerosis: 'Association of British Neurologists' guidelines","volume":"19","author":"Dobson","year":"2019","journal-title":"Pract. Neurol"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0060","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/pn-2022-003426","article-title":"Anti-CD20 therapies in pregnancy and breast feeding: a review and ABN guidelines","volume":"23","author":"Dobson","year":"2023","journal-title":"Pract. Neurol"},{"key":"10.1016\/j.msard.2025.106643_bib0058","unstructured":"Dobson R., Vukusic S., Bove R., Hellwig K., Krysko K.M., Pietrasanta C., et al. Pregnancy and infant outcomes in women with multiple sclerosis receiving Ocrelizumab: analysis of approximately 4000 pregnancies to date [Poster presentation]. 40th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS); 18-20 September 2024; Copenhagen, Denmark."},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0012","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1177\/13524585231161492","article-title":"Multiple sclerosis, disease-modifying drugs and risk for adverse perinatal and pregnancy outcomes: results from a population-based cohort study","volume":"29","author":"Fink","year":"2023","journal-title":"Mult. Scler"},{"issue":"7","key":"10.1016\/j.msard.2025.106643_bib0015","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/j.1471-0528.2011.02931.x","article-title":"What can we really tell women with multiple sclerosis regarding pregnancy? A systematic review and meta-analysis of the literature","volume":"118","author":"Finkelsztejn","year":"2011","journal-title":"Bjog"},{"issue":"11","key":"10.1016\/j.msard.2025.106643_bib0046","first-page":"969","article-title":"Long-term use of glatiramer acetate by 11 pregnant women with multiple sclerosis: a retrospective, multicentre case series","volume":"24","author":"Fragoso","year":"2010","journal-title":"CNS Drugs"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0039","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.clineuro.2012.04.024","article-title":"The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis","volume":"115","author":"Fragoso","year":"2013","journal-title":"Clin. Neurol. Neurosurg"},{"issue":"10","key":"10.1016\/j.msard.2025.106643_bib0080","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1080\/07399332.2014.948627","article-title":"Postpartum treatment with immunoglobulin does not prevent relapses of multiple sclerosis in the mother","volume":"36","author":"Fragoso","year":"2015","journal-title":"Health Care Women Int"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0038","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000127972","article-title":"Efficacy of disease-modifying therapies in relapsing remitting multiple sclerosis: a systematic comparison","volume":"60","author":"Freedman","year":"2008","journal-title":"Eur. Neurol"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0017","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1136\/jnnp.51.4.495","article-title":"Pregnancy and multiple sclerosis","volume":"51","author":"Frith","year":"1988","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"issue":"5","key":"10.1016\/j.msard.2025.106643_bib0055","doi-asserted-by":"crossref","DOI":"10.3390\/ph16050770","article-title":"Monoclonal antibodies in pregnancy and breastfeeding in patients with multiple sclerosis: a review and an updated clinical guide","volume":"16","author":"Gklinos","year":"2023","journal-title":"Pharmaceuticals (Basel)"},{"issue":"3","key":"10.1016\/j.msard.2025.106643_bib0083","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/ctn8030026","article-title":"Recommendations for the treatment of multiple sclerosis in Family planning, Pregnancy and Lactation in Switzerland: Immunotherapy","volume":"8","author":"Graber","year":"2024","journal-title":"Clin. Translat. Neurosci."},{"issue":"8","key":"10.1016\/j.msard.2025.106643_bib0034","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1523\/JNEUROSCI.4441-06.2007","article-title":"White matter plasticity and enhanced remyelination in the maternal CNS","volume":"27","author":"Gregg","year":"2007","journal-title":"J. Neurosci"},{"issue":"7","key":"10.1016\/j.msard.2025.106643_bib0077","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1177\/1352458506075654","article-title":"A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis","volume":"13","author":"Haas","year":"2007","journal-title":"Mult. Scler"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0078","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/1756285608100416","article-title":"Immunomodulation and postpartum relapses in patients with multiple sclerosis","volume":"2","author":"Hellwig","year":"2009","journal-title":"Ther. Adv. Neurol. Disord"},{"issue":"8","key":"10.1016\/j.msard.2025.106643_bib0053","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1177\/1352458511401944","article-title":"Pregnancy and natalizumab: results of an observational study in 35 accidental pregnancies during natalizumab treatment","volume":"17","author":"Hellwig","year":"2011","journal-title":"Mult. Scler"},{"issue":"5","key":"10.1016\/j.msard.2025.106643_bib0024","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/1756285612453192","article-title":"Multiple sclerosis and pregnancy: experience from a nationwide database in Germany","volume":"5","author":"Hellwig","year":"2012","journal-title":"Ther. Adv. Neurol. Disord"},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0050","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1007\/s00415-020-09762-y","article-title":"Pregnancy outcomes in interferon-beta-exposed patients with multiple sclerosis: results from the European Interferon-beta Pregnancy Registry","volume":"267","author":"Hellwig","year":"2020","journal-title":"J. Neurol"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0023","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000200110","article-title":"Multiple sclerosis disease activity and disability following cessation of Fingolimod for pregnancy","volume":"10","author":"Hellwig","year":"2023","journal-title":"Neurol. Neuroimmunol. Neuroinflamm"},{"key":"10.1016\/j.msard.2025.106643_bib0081","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2019.101519","article-title":"Intravenous immunoglobulins for the prevention of postpartum relapses in multiple sclerosis","volume":"38","author":"Horvat Ledinek","year":"2020","journal-title":"Mult. Scler. Relat. Disord"},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0069","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.2214\/AJR.06.1616","article-title":"ACR guidance document for safe MR practices: 2007","volume":"188","author":"Kanal","year":"2007","journal-title":"AJR Am. J. Roentgenol"},{"issue":"3","key":"10.1016\/j.msard.2025.106643_bib0026","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1001\/jamaneurol.2019.4173","article-title":"Association between breastfeeding and postpartum multiple sclerosis relapses: a systematic review and meta-analysis","volume":"77","author":"Krysko","year":"2020","journal-title":"JAMA Neurol"},{"issue":"11","key":"10.1016\/j.msard.2025.106643_bib0006","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1212\/WNL.33.11.1444","article-title":"Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983","journal-title":"Neurology"},{"issue":"18","key":"10.1016\/j.msard.2025.106643_bib0018","doi-asserted-by":"crossref","first-page":"e1939","DOI":"10.1212\/WNL.0000000000009374","article-title":"Pregnancy-related relapses and breastfeeding in a contemporary multiple sclerosis cohort","volume":"94","author":"Langer-Gould","year":"2020","journal-title":"Neurology"},{"issue":"3","key":"10.1016\/j.msard.2025.106643_bib0002","article-title":"Potential protective role of pregnancy and breastfeeding in delaying onset symptoms related to multiple sclerosis","volume":"59","author":"Logoteta","year":"2023","journal-title":"Medicina (Kaunas)"},{"issue":"9","key":"10.1016\/j.msard.2025.106643_bib0044","doi-asserted-by":"crossref","first-page":"2721","DOI":"10.1007\/s00415-020-09913-1","article-title":"A systematic review and meta-analyses of pregnancy and fetal outcomes in women with multiple sclerosis: a contribution from the IMI2 ConcePTION project","volume":"267","author":"Lopez-Leon","year":"2020","journal-title":"J. Neurol"},{"issue":"11","key":"10.1016\/j.msard.2025.106643_bib0040","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1212\/WNL.0b013e3182698c64","article-title":"Disease-modifying drugs for multiple sclerosis in pregnancy: a systematic review","volume":"79","author":"Lu","year":"2012","journal-title":"Neurology"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0011-5029(96)90012-7","article-title":"Multiple sclerosis","volume":"42","author":"Lynch","year":"1996","journal-title":"Dis. Mon"},{"key":"10.1016\/j.msard.2025.106643_bib0064","first-page":"410","article-title":"Regenerating immunotolerance in multiple sclerosis with","volume":"9","author":"Massey","year":"2018","journal-title":"Autologous Hematopoietic Stem Cell Transplant. Front Immunol."},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0075","article-title":"Intravenous immunoglobulin treatment during pregnancy and the post-partum period in women with multiple sclerosis: a prospective analysis","volume":"9","author":"Menascu","year":"2023","journal-title":"Mult. Scler. J. Exp. Transl. Clin"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0005","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.nrl.2016.06.005","article-title":"Multiple sclerosis: pregnancy and women's health issues","volume":"34","author":"Mendibe Bilbao","year":"2019","journal-title":"Neurologia (Engl Ed)"},{"issue":"9","key":"10.1016\/j.msard.2025.106643_bib0011","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1136\/jnnp-2022-330883","article-title":"Fertility, pregnancy and childbirth in women with multiple sclerosis: a population-based study from 2018 to 2020","volume":"94","author":"Moccia","year":"2023","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"issue":"3","key":"10.1016\/j.msard.2025.106643_bib0019","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2217\/cer-2020-0211","article-title":"The effects of pregnancy on relapse rates, disability and peripartum outcomes in women with multiple sclerosis: a systematic review and meta-analysis","volume":"10","author":"Modrego","year":"2021","journal-title":"J. Comp. Eff. Res"},{"issue":"5","key":"10.1016\/j.msard.2025.106643_bib0068","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1001\/jamaneurol.2015.4800","article-title":"Vitamin D status during pregnancy and risk of multiple sclerosis in offspring of women in the Finnish maternity cohort","volume":"73","author":"Munger","year":"2016","journal-title":"JAMA Neurol"},{"key":"10.1016\/j.msard.2025.106643_bib0008","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2024.105893","article-title":"Multiple sclerosis: pregnancy, fertility, and assisted reproductive technology-a review","volume":"92","author":"Oreja-Guevara","year":"2024","journal-title":"Mult. Scler. Relat. Disord"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0079","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0301-2115(98)00231-0","article-title":"Pregnancy and multiple sclerosis: a 2-year experience","volume":"82","author":"Orvieto","year":"1999","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol"},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0072","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1002\/1096-9926(200012)62:6<385::AID-TERA5>3.0.CO;2-Z","article-title":"Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies","volume":"62","author":"Park-Wyllie","year":"2000","journal-title":"Teratology"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0029","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1016\/S0002-9440(10)63516-X","article-title":"The protective effect of 17beta-estradiol on experimental autoimmune encephalomyelitis is mediated through estrogen receptor-alpha","volume":"163","author":"Polanczyk","year":"2003","journal-title":"Am. J. Pathol"},{"issue":"10","key":"10.1016\/j.msard.2025.106643_bib0073","doi-asserted-by":"crossref","DOI":"10.3390\/jcm8101623","article-title":"Therapeutic apheresis in acute relapsing multiple sclerosis: current evidence and unmet needs-A systematic review","volume":"8","author":"Rolfes","year":"2019","journal-title":"J. Clin. Med"},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0082","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1590\/0004-282x20180041","article-title":"There is no benefit in the use of postnatal intravenous immunoglobulin for the prevention of relapses of multiple sclerosis: findings from a systematic review and meta-analysis","volume":"76","author":"Rosa","year":"2018","journal-title":"Arq. Neuropsiquiatr"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0062","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1001\/jamaneurol.2014.3537","article-title":"Evaluation of no evidence of disease activity in a 7-year longitudinal multiple sclerosis cohort","volume":"72","author":"Rotstein","year":"2015","journal-title":"JAMA Neurol"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0035","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1093\/brain\/118.1.253","article-title":"Pregnancy is associated with a lower risk of onset and a better prognosis in multiple sclerosis","volume":"118","author":"Runmarker","year":"1995","journal-title":"Brain"},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0048","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1212\/01.wnl.0000168905.97207.d0","article-title":"Pregnancy outcomes during treatment with interferon beta-1a in patients with multiple sclerosis","volume":"65","author":"Sandberg-Wollheim","year":"2005","journal-title":"Neurology"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0043","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/1352458510394610","article-title":"Pregnancy outcomes in multiple sclerosis following subcutaneous interferon beta-1a therapy","volume":"17","author":"Sandberg-Wollheim","year":"2011","journal-title":"Mult. Scler"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0056","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s40618-019-01105-7","article-title":"Alemtuzumab-induced thyroid events in multiple sclerosis: a systematic review and meta-analysis","volume":"43","author":"Scappaticcio","year":"2020","journal-title":"J. Endocrinol. Invest"},{"issue":"9","key":"10.1016\/j.msard.2025.106643_bib0025","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1136\/jnnp-2022-330533","article-title":"Postpartum relapse risk in multiple sclerosis: a systematic review and meta-analysis","volume":"94","author":"Schubert","year":"2023","journal-title":"J Neurol. Neurosurg. Psychiatry"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0065","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1038\/s41409-019-0684-0","volume":"55","author":"Sharrack","year":"2020","journal-title":"Bone Marrow Transplant"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0032","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1002\/ana.10301","article-title":"Treatment of multiple sclerosis with the pregnancy hormone estriol","volume":"52","author":"Sicotte","year":"2002","journal-title":"Ann. Neurol"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0054","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000734","article-title":"Rituximab, MS, and pregnancy","volume":"7","author":"Smith","year":"2020","journal-title":"Neurol. Neuroimmunol. Neuroinflamm"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0066","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1038\/bmt.2014.248","article-title":"Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP)","volume":"50","author":"Snarski","year":"2015","journal-title":"Bone Marrow Transplant"},{"issue":"11","key":"10.1016\/j.msard.2025.106643_bib0028","doi-asserted-by":"crossref","first-page":"6267","DOI":"10.4049\/jimmunol.171.11.6267","article-title":"Immune modulation in multiple sclerosis patients treated with the pregnancy hormone estriol","volume":"171","author":"Soldan","year":"2003","journal-title":"J. Immunol"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0013","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/13524585231223395","article-title":"Use of multiple sclerosis disease-modifying therapies during pregnancy in France: nationwide study between 2010 and 2021","volume":"30","author":"Swital","year":"2024","journal-title":"Mult. Scler"},{"key":"10.1016\/j.msard.2025.106643_bib0051","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2020.101961","article-title":"Pregnancy outcomes amongst multiple sclerosis females with third trimester natalizumab use","volume":"40","author":"Triplett","year":"2020","journal-title":"Mult. Scler. Relat. Disord"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0014","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/ana.22483","article-title":"Tremlett H. Neonatal and delivery outcomes in women with multiple sclerosis","volume":"70","author":"van der Kop","year":"2011","journal-title":"Ann. Neurol"},{"issue":"2","key":"10.1016\/j.msard.2025.106643_bib0057","article-title":"Pregnancy and Multiple sclerosis: an update on the disease modifying treatment strategy and a review of Pregnancy's impact on disease activity","volume":"56","author":"Varyt\u0117","year":"2020","journal-title":"Medicina (Kaunas)"},{"issue":"5","key":"10.1016\/j.msard.2025.106643_bib0061","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/GCO.0000000000000731","article-title":"Pregnancy and multiple sclerosis: an update","volume":"33","author":"Varyt\u0117","year":"2021","journal-title":"Curr. Opin. Obstet. Gynecol"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0037","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1007\/s13311-017-0562-7","article-title":"Pregnancy: effect on multiple sclerosis, treatment considerations, and breastfeeding","volume":"14","author":"Voskuhl","year":"2017","journal-title":"Neurotherapeutics"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0033","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S1474-4422(15)00322-1","article-title":"Estriol combined with glatiramer acetate for women with relapsing-remitting multiple sclerosis: a randomised, placebo-controlled, phase 2 trial","volume":"15","author":"Voskuhl","year":"2016","journal-title":"Lancet Neurol"},{"issue":"6","key":"10.1016\/j.msard.2025.106643_bib0020","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1093\/brain\/awh152","article-title":"Pregnancy and multiple sclerosis (the PRIMS study): clinical predictors of post-partum relapse","volume":"127","author":"Vukusic","year":"2004","journal-title":"Brain"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0059","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000200349","article-title":"Pregnancy and infant outcomes in women with multiple sclerosis treated with Ocrelizumab","volume":"12","author":"Vukusic","year":"2025","journal-title":"Neurol. Neuroimmunol. Neuroinflamm"},{"issue":"14","key":"10.1016\/j.msard.2025.106643_bib0007","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition","volume":"26","author":"Walton","year":"2020","journal-title":"Mult. Scler"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0071","doi-asserted-by":"crossref","first-page":"778","DOI":"10.2214\/AJR.11.7405","article-title":"Imaging of pregnant and lactating patients: part 1, evidence-based review and recommendations","volume":"198","author":"Wang","year":"2012","journal-title":"AJR Am. J. Roentgenol"},{"issue":"9","key":"10.1016\/j.msard.2025.106643_bib0045","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1177\/1352458509106543","article-title":"Multiple sclerosis, immunomodulators, and pregnancy outcome: a prospective observational study","volume":"15","author":"Weber-Schoendorfer","year":"2009","journal-title":"Mult. Scler"},{"key":"10.1016\/j.msard.2025.106643_bib0047","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1162796","article-title":"Interferon beta treatment is a potent and targeted epigenetic modifier in multiple sclerosis","volume":"14","author":"Xavier","year":"2023","journal-title":"Front. Immunol"},{"issue":"4","key":"10.1016\/j.msard.2025.106643_bib0067","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0284288","article-title":"Anti-M\u00fcllerian hormone and pregnancy after autologous hematopoietic stem cell transplantation for multiple sclerosis","volume":"18","author":"Zafeiri","year":"2023","journal-title":"PLoS One"},{"issue":"1","key":"10.1016\/j.msard.2025.106643_bib0031","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/s12974-023-02781-2","article-title":"Prominent epigenetic and transcriptomic changes in CD4(+) and CD8(+) T cells during and after pregnancy in women with multiple sclerosis and controls","volume":"20","author":"Zenere","year":"2023","journal-title":"J. Neuroinflammation"},{"issue":"8","key":"10.1016\/j.msard.2025.106643_bib0052","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1136\/jnnp-2015-312940","article-title":"Extended interval dosing of natalizumab in multiple sclerosis","volume":"87","author":"Zhovtis Ryerson","year":"2016","journal-title":"J. Neurol. Neurosurg. Psychiatry"}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034825003852?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034825003852?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T07:22:22Z","timestamp":1780039342000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211034825003852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":83,"alternative-id":["S2211034825003852"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2025.106643","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pregnancy and Multiple Sclerosis: A Narrative Review of Clinical Outcomes, Disease Activity, and Treatment Considerations","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2025.106643","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"106643"}}