Unmet need for family planning and fertility preferences in women with multiple sclerosis

Abstract

<h3>Background</h3> Most women with multiple sclerosis (wMS) have childbearing potential and the indication of disease-modifying drugs (DMD) may hinder reproductive decision-making due to their teratogenic potential and risk of pregnancy-related complications. We aimed to assess the frequency of unmet need for family planning (UNFP) and reproductive history in relation to clinical and demographic variables of wMS. <h3>Methods</h3> This is a cross-sectional observational study. Telephone surveys were applied to a random sample of wMS. The proportion of pregnancies exposed to DMDs, use of contraceptives, and UNFP was calculated. The factors associated with fertility preferences were evaluated through bivariate and multivariate analysis. <h3>Results</h3> 141 wMS were surveyed. 86.8% of 105 sexually active women were using contraceptives. 82 pregnancies were identified of which 48 occurred after MS diagnosis and 25 were exposed to DMDs. UNFP was estimated at 4.95%. Among 100 wMS with childbearing potential, 48 did not want to have children, 33 wanted to have more children and 19 were undecided. No MS related variables were associated with fertility preferences. Only increasing age (OR 0.89; 95%CI 0.83–0.96) and the number of previous children (OR 0.26; 95%CI 0.11–0.65) decreased the likelihood of wMS having gestational desire. <h3>Conclusion</h3> UNFP and a high proportion of pregnancies that were exposed to DMDs show the need to implement and improve reproductive health services for wMS. No association was found between gestational desire and clinical variables. <h3>Keywords</h3> Multiple sclerosis, Family planning, Unmet need for family planning, Fertility preferences <b>Disclosures:</b> LL-R has received travel expenses for scientific meetings from Roche, Tecnofarma and Biogen-Idec, and speaking honoraria from Merck, Roche and Biogen-Idec. CG-S reports consulting fees from Novartis, Biogen-Idec, Sanofi-Genzyme, Merck and Roche, and has received travel expenses for scientific meetings from Sanofi-Genzyme, Abbot and Merck. SC-R was an ECTRIMS clinical fellowship awardee 20192020, has received travel expenses for scientific meetings from Genzyme, received compensation for consulting services or participation on advisory boards from Merck, Roche, Biogen-Idec and Novartis, received speaking honoraria from Novartis, and received research support from Biogen-Idec. <b>Acknowledgements:</b> Catalina González Uribe and Michael Steven Carvajal. <b>Reference</b> Bradley, S.E.K., Croft, T.N., Fishel, J.D., Westoff, C.F. Revising unmet need for family planning. ICF International; Calverton, MD: 2012. DHS Analytical Studies No. 25.