Pregnancy outcome in patients with multiple sclerosis: A retrospective study from single center in Benghazi, Libya

Anwaar  Mukhtar Bennour; Magda  Elshukri; Naziha  Amer; Heba  El-Zawawi; Abdulhameed  Zawawi

doi:10.18502/cjn.v24i1.20300

Anwaar Mukhtar Bennour Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya
Magda Elshukri Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya
Naziha Amer Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya
Heba El-Zawawi Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya
Abdulhameed Zawawi Department of Internal Medicine, Neurology Unit, Multiple Sclerosis Clinic, Benghazi Medical Center, Benghazi, Libya

DOI: https://doi.org/10.18502/cjn.v24i1.20300

Keywords: Pregnancy; Multiple Sclerosis; Postpartum Period; Recurrence; Breast Feeding; Libya

Abstract

Background: Misconceptions about multiple sclerosis (MS), pregnancy, and disease-modifying therapies (DMTs) are common, often driven by fears that DMTs pose risks to the fetus or that pregnancy will exacerbate the disease. This study aimed to evaluate and document local clinical practices and decision-making processes in the management of women with MS regarding DMT use during pregnancy.

Methods: A retrospective review was conducted at the MS Clinic of Benghazi Medical Center, Benghazi, Libya, from January 1, 2016 to December 31, 2019. Medical records of women meeting the 2017 McDonald’s criteria for MS diagnosis were analyzed. Data collected included demographic and clinical variables, pregnancy outcomes, DMT use, and postpartum care. Statistical analysis was performed using SPSS software.

Results: Thirty-six women (61 pregnancies) were included. The median age was 36 years (range: 24-56). Unplanned pregnancies occurred in 24/36 women, 32/61 pregnancies (52%). Only five women continued DMTs during pregnancy. Uncomplicated pregnancies occurred in 30/36 women (83%), while postpartum relapses were reported in 12 women (33%), 11 with unplanned pregnancies. The median time to DMT resumption postpartum was 4 months. Breastfeeding was practiced for a median duration of 4 months. Preconception magnetic resonance imaging (MRI) was performed in 6 women (16.6%).

Conclusion: This study provides valuable insights into the management of MS during pregnancy in Libya. While the sample size is small, the findings underscore the importance of standardized guidelines for DMT use, pregnancy planning, and postpartum care. Future studies with larger cohorts and broader DMT options are needed.