Current approaches to multiple sclerosis management in pregnancy

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This article reviews literature data on the impact of multiple sclerosis (MS) on fertility and pregnancy outcomes, the specifics of using disease- modifying therapies (DMTs), and breastfeeding practices. The results demonstrate that fertility rates in women with MS do not differ from the general population, and the frequency of pregnancy complications, including stillbirths, congenital malformations, and spontaneous abortions, does not exceed population-level rates. A reduction in MS activity is observed during the third trimester of pregnancy; however, the risk of relapses increases by 50% within the first three months postpartum, necessitating timely resumption of therapy. Pregnancy management in women with MS should involve interdisciplinary collaboration between neurologists and obstetricians and gynecologists, personalized therapy adjustments, and patient education about safe treatment strategies. Certain DMTs can be safely used during pregnancy and lactation, though careful benefit-risk assessment remains crucial. Women with MS can successfully plan and carry pregnancies to term without significant untoward effects on outcomes. Developing personalized management strategies for these patients will help minimize risks and improve their quality of life.