Abstract
Interferon-beta (IFN-beta) is a commonly used treatment for multiple sclerosis (MS). Current guidelines recommend cessation of treatment during pregnancy, however the results of past studies on the safety of prenatal exposure to IFN-beta have been conflicting. A large scale study of a population of MS women is therefore warranted. To assess whether, among those born to women with MS, infants prenatally exposed to IFN-beta show evidence of smaller size at birth relative to infants which were not prenatally exposed to any MS disease modifying drugs. Swedish and Finnish register data was used. Births to women with MS in Sweden and Finland between 2005-2014 for which a birth measurement for weight, height, and head circumference was available were included. The exposure window was from 6 months prior to LMP to the end of pregnancy. In Sweden, 411 pregnancies were identified as exposed to IFN-beta during the exposure window, and 835 pregnancies were counted as unexposed to any MS DMD. The corresponding numbers for Finland were 232 and 331 respectively. Infants prenatally exposed to interferon-beta were on average 28 grams heavier (p = 0.17), 0.01 cm longer (p = 0.95), and had head circumferences 0.14 cm larger (p = 0.13) in Sweden. In Finland, infants were 50 grams lighter (p = 0.27), 0.02 cm shorter (p = 0.92) and had head circumferences 0.22 cm smaller (p = 0.15) relative to those unexposed. This study provides evidence that exposure to IFN-beta during pregnancy does not influence birth weight, length, or head circumference.
Highlights
Multiple sclerosis (MS) is an immune mediated disease causing demyelination and axonal loss in the central nervous system (CNS) [1]
In Sweden, 411 pregnancies were identified as exposed to IFN-beta during the exposure window, and 835 pregnancies were counted as unexposed to any MS disease modifying drugs (DMD)
Infants prenatally exposed to interferon-beta were on average 28 grams heavier (p = 0.17), 0.01 cm longer (p = 0.95), and had head circumferences 0.14 cm larger (p = 0.13) in Sweden
Summary
Multiple sclerosis (MS) is an immune mediated disease causing demyelination and axonal loss in the central nervous system (CNS) [1]. Interferon beta (IFN-beta) is a commonly used disease modifying treatment for MS, with current guidelines recommending cessation during pregnancy. Pregnant women are often excluded from clinical trials, meaning the effects of prenatal exposure are not known, resulting in a preference to cease treatment. Not all pregnancies are planned and some women will conceive whilst on treatment, making foetal exposure to IFN-beta inevitable in some instances. Given conflicting outcomes in past research [4,5,6,7,8,9], an investigation into potential adverse pregnancy outcomes related to foetal exposure to IFN-beta using larger populations of women with MS rather than smaller samples is warranted. Current guidelines recommend cessation of treatment during pregnancy, the results of past studies on the safety of prenatal exposure to IFN-beta have been conflicting. A large scale study of a population of MS women is warranted
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