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Pract Neurol. 2019 Apr;19(2):106-114. doi: 10.1136/practneurol-2018-002060. Epub 2019 Jan 5.

UK consensus on pregnancy in multiple sclerosis: 'Association of British Neurologists' guidelines.

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Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
Department of Neurology, Barts Health NHS Trust, Royal London Hospital, London, UK.
Department of Neurology, Imperial College Healthcare NHS Trust, London, UK.
Department of Neurology, Ealing Hospital, London North West Healthcare NHS Trust, London, UK.
MS Trust, London, UK.
Blizard Institute, Queen Mary University of London, London, UK.
Department of Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Queen Charlotte's Hospital, Imperial College Healthcare Trust, London, UK.
Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK.


Multiple sclerosis (MS) is more common in women than men and is most commonly diagnosed in early adulthood; thus, many patients will not have completed their families at the time of diagnosis. There is increasing awareness of the importance of early treatment in preventing long-term disability in MS. Delaying treatment until women with MS have completed their families can lead to the development of irreversible disability in at least some cases. It is therefore important to discuss family planning and pregnancy proactively. However, to date there is limited evidence to inform such discussions. We set out to develop consensus guidelines for the treatment of MS in pregnancy to encourage and facilitate discussions in this important area. The guidelines draw on available evidence from drug-specific pregnancy registers and published literature and have been scored by a panel of experts from a variety of disciplines using modified Delphi criteria. They cover prepregnancy counselling, management during pregnancy, delivery and anaesthetic options, postpartum advice and specific advice regarding currently licensed disease-modifying drugs. As the complexity and range of available disease-modifying drugs increase, further data gathering via a UK-wide MS pregnancy register is recommended.


disease modifying therapy; multiple sclerosis; pregnancy

Conflict of interest statement

Competing interests: None declared.

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