Original article Pavel Hradílek, MD, Ph.D. from the University Hospital Ostrava based on data from the ReMuS registry was published in the professional journal Multiple Sclerosis and Related Disorders.
Hradilek, P., Zapletalova, O., Hanulikova, P., Havrdova, E. K., Woznicova, I., Mazouchova, A., Drahota, J., Lauer, M., Stetkarova, I., Valis, M., Libertinova, J., Stourac, P., Adamkova, J., Ampapa, R., Vachova, M., Dufek, M., Martinkova, A., Peterka, M., Recmanova, E., Mares, J. Horakova, D. (2023). Is breastfeeding in MS harmful or not? An answer from real-world Czech data. And Multiple Sclerosis and Related Disorders (Vol. 76, p. 104790). Elsevier BV. https://doi.org/10.1016/j.msard.2023.104790 PMID: 37348317
Abstract
Introduction: The effect of breastfeeding and its duration on the course of multiple sclerosis (MS) is unclear. In this study, we analyzed real data on breastfeeding women with MS and the course of their disease obtained from the Czech national ReMuS registry.
Objectives: The aim was to identify risk factors associated with not initiating breastfeeding after delivery, to analyze the effect of breastfeeding on the course of MS, to evaluate the assumption that breastfeeding is not harmful in MS patients, and to compare the course of the disease according to breastfeeding status.
Procedure and methods: Using propensity score matching, we compared Expanded Disability Status Scale (EDSS), confirmed disease worsening (CDW), and annual relapse rate (ARR) in breastfeeding and non-breastfeeding MS patients by disease duration, disease-modifying treatment (DMT) before pregnancy, last EDSS score before conception, age, and ARR during pregnancy. We also compared these parameters between breastfeeding patients not taking DMT and non-lactating patients who resumed DMT within 3 months after delivery. EDSS, ARR and CDW were collected at 12, 24 and 36 months postpartum.
Results: Between 2013 and 2020, a total of 1681 pregnancies that ended in delivery were analysed. The change in ARR and EDSS and CDW values at 6 months did not differ significantly between the groups analysed. Compared to non-lactating women who resumed DMT soon after delivery, lactating women with MS did not have a worse outcome.
Discussion: Breastfeeding in Czech women with MS had no negative effect on the course of the disease and can be supported. MS patients can be treated with some DMTs in addition to breastfeeding and it is not necessary to discontinue breastfeeding if the patient is clinically stable.
The full article is available in English by logging in to the journal's website Multiple Sclerosis and Related Disorders.
