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The pregnancy\u2010associated reduction in the relapse rate, especially in the third trimester, is followed by a sharp increase in the first few months postpartum. Nevertheless, retrospective evidence for pregnant women with and without <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> followed for up to 10\u00a0years indicates that pregnancy has no perceptible effect on long\u2010term disease course or disability progression. Likewise, <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> has no\u00a0apparent effects on the pregnancy course or fetal outcomes. All disease\u2010modifying therapies (<jats:styled-content style=\"fixed-case\">DMT<\/jats:styled-content>s) have potential adverse effects on fertility and pregnancy outcomes, but the level of risk varies amongst agents. There is some support for continued use of interferon\u2010\u03b2 and glatiramer acetate throughout pregnancy to reduce the risk of relapse. Use of <jats:styled-content style=\"fixed-case\">DMT<\/jats:styled-content>s during breastfeeding is best avoided if possible. Close evaluation of drug safety information is imperative when managing women with <jats:styled-content style=\"fixed-case\">MS<\/jats:styled-content> who are pregnant or wish to become pregnant. Decision\u2010making should be a shared experience between patient and physician, and the approach must be individualized for each patient.<\/jats:p>","DOI":"10.1111\/ene.12797","type":"journal-article","created":{"date-parts":[[2015,9,16]],"date-time":"2015-09-16T10:06:53Z","timestamp":1442398013000},"page":"34-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["An overview of pregnancy\u2010related issues in patients with multiple sclerosis"],"prefix":"10.1111","volume":"22","author":[{"given":"C.","family":"Pozzilli","sequence":"first","affiliation":[{"name":"Department of Neurology and Psychiatry Sapienza University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Pugliatti","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Specialty Surgical Sciences University of Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807303390501"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh152"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02931.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513507816"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0453-06.2006"},{"key":"e_1_2_11_7_1","unstructured":"PozzilliC De GiglioL BarlettaV et\u00a0al.Efficacy and safety of oral contraceptives as add\u2010on therapy in patients with relapsing\u2212remitting multiple sclerosis receiving subcutaneous interferon beta\u20101a: a multicenter randomized investigator\u2010run clinical trial [Abstract 171]. 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