{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:06:13Z","timestamp":1785236773636,"version":"3.55.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100018892","name":"F\u00f6rs\u00e4kringskassan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018892","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Managing family planning and treatment in women with multiple sclerosis (MS) requires balancing disease control with medication safety. Despite guidelines, practice often adapts to individual needs, with clinicians adjusting disease-modifying therapies (DMTs) to protect maternal and fetal health. This study examines pregnancy-related MS treatment in Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified 130 women (153 pregnancies) from a 2021 online MS questionnaire and linked responses to the Swedish MS register to capture DMT use during three periods: 25 weeks before conception, pregnancy (\u224840 weeks), and 25 weeks postpartum. DMTs were classified as \u201caccepted,\u201d \u201cdiscontinuation recommended\u201d\u2014requiring monitoring, or \u201cnot recommended\u201d in planned pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Before conception, among 153 pregnancies, 26% involved DMTs considered acceptable before and during pregnancy, while 55% involved DMTs for which discontinuation before conception is recommended\u2014of which rituximab accounted for nearly half of all pregnancies (47%, n\u2009=\u200972). Three percent were exposed to \u00b4not recommended\u00b4 DMTs, and 16% had no prior treatment. Overall, 29% discontinued DMTs before or shortly after conception, while 58% (n\u2009=\u200988) had ongoing or recent treatment exposure, defined as treatment administered within 6 months before conception or, in a minority of cases, after conception. Among these, 50% (n\u2009=\u200977) involved rituximab\u2014and 13% remained untreated. Postpartum, 58% resumed treatment, 3% remained under long-lasting DMT effects, and 39% did not initiate DMT, likely due to breastfeeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Overall, real-world practice in Sweden broadly aligns with national recommendations, with widespread use of rituximab before pregnancy reflecting its perceived safety and durable effect, alongside some individualized deviations from discontinuation guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552173261472249","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:37:16Z","timestamp":1784900236000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Family planning and multiple sclerosis \u2013 part 2: Does real-world practice align with Swedish treatment guidelines?"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8957-661X","authenticated-orcid":false,"given":"Alejandra","family":"Machado","sequence":"first","affiliation":[{"name":"Division of Insurance Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4776-9162","authenticated-orcid":false,"given":"Emma","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Division of Insurance Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6182-499X","authenticated-orcid":false,"given":"Fitsum Sebsibe","family":"Teni","sequence":"additional","affiliation":[{"name":"Division of Insurance Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7874-4243","authenticated-orcid":false,"given":"Emilie","family":"Friberg","sequence":"additional","affiliation":[{"name":"Division of Insurance Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Fink","sequence":"additional","affiliation":[{"name":"Division of Neuro"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"493","article-title":"Multiple sclerosis in pregnancy and its role in female fertility: a systematic review","volume":"25","author":"Lamaita R","year":"2021","unstructured":"Lamaita R, Melo C, Laranjeira C, et al. Multiple sclerosis in pregnancy and its role in female fertility: a systematic review. JBRA Assist Reprod 2021; 25: 493\u2013499.","journal-title":"JBRA Assist Reprod"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00426-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09913-1"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.06.006"},{"key":"e_1_3_3_6_2","unstructured":"National Board of Health and Welfare [Socialstyrelsen]. Nationella riktlinjer: v\u00e5rd vid multipel skleros och Parkinsons sjukdom \u2013 st\u00f6d f\u00f6r styrning och ledning [National guidelines for care in multiple sclerosis and Parkinson's disease: support for steering and management]. Stockholm: Socialstyrelsen; 2022 [cited 2026 Jan 28]. Available from: https:\/\/www.socialstyrelsen.se\/kunskapsstod-och-regler\/regler-och-riktlinjer\/nationella-riktlinjer\/riktlinjer-och-utvarderingar\/ms-och-parkinsons-sjukdom\/om-riktlinjerna-for-patienter\/."},{"key":"e_1_3_3_7_2","unstructured":"Fink K. Behandlingsrekommendationer f\u00f6r kvinnor med MS i barnaf\u00f6dande \u00e5lder [Treatment recommendations for women with MS of childbearing age]. In: METODBOK MS. Stockholm: Svenska MS s\u00e4llskapet [Swedish MS Society]; 2024. [cited 2026 Jan 28]. Available from: https:\/\/www.mssallskapet.se\/metodbok\/.."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000731"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102694"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12963"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26914"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000903"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000453"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.101137"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-330883"}],"container-title":["Multiple Sclerosis Journal \u2013 Experimental, Translational and Clinical"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552173261472249","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20552173261472249","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20552173261472249","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:51:11Z","timestamp":1785235871000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20552173261472249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/20552173261472249"],"URL":"https:\/\/doi.org\/10.1177\/20552173261472249","relation":{},"ISSN":["2055-2173","2055-2173"],"issn-type":[{"value":"2055-2173","type":"print"},{"value":"2055-2173","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"20552173261472249"}}