Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis

Paolo Ragonese, Giuseppe Salemi, Luca Prosperini, Giorgia Mataluni, Doriana Landi, Fabrizia Monteleone, Antonio Cortese, Elisabetta Ferraro, Marco Salvetti, Maria Chiara Buscarinu, Simona Pontecorvo, Diego Centonze, Ada Francia, Shalom Haggiag, Girolama Alessandra Marfia, Viviana Nociti, Laura Boffa, Massimiliano Mirabella, Enrico Millefiorini, Claudio GasperiniRoberta Fantozzi, Carlo Pozzilli, Giancarlo Di Battista

Risultato della ricerca: Article

1 Citazione (Scopus)

Abstract

OBJECTIVE:To investigate clinical and radiological outcomes of women with relapsing-remitting multiple sclerosis (RRMS) undergoing abortion.METHODS:An independent, multicentre retrospective study was conducted collecting data from eight Italian MS centres. We compared the preconception and postabortion annualised relapse rate (ARR) and number of Gadolinium enhancing (Gd+) lesions, by analyses of covariance. Variables associated with postabortion clinical and MRI activity were investigated using Poisson regression models; each abortion was considered as a statistical unit.RESULTS:From 1995 to 2017, we observed 188 abortions (17 elective) in 153 women with RRMS. Abortions occurred after a mean time of 9.5 (4.4) weeks from estimated conception date. In 86 events out of 188, conception happened during treatment with disease modifying drugs. The mean postabortion ARR (0.63±0.74) was significantly increased (p=0.037) compared with the preconception year (0.50±0.71) as well as the postabortion mean number of new Gd+ lesions (0.77±1.40 vs 0.39±1.04; p=0.004). Higher likelihood of relapses was predicted by higher preconception ARR, discontinuation of preconception treatment and elective abortion; the occurrence of new Gd+ lesions was associated with higher preconception number of active lesions, discontinuation of preconception treatment, shorter length of pregnancy maintenance and elective abortion.CONCLUSIONS:Abortion was associated with clinical and radiological inflammatory rebound remarkably in the first 12 months postevent. Deregulated proinflammatory processes arising at the early stages of pregnancy might play a role both in MS reactivation and abortion. Women with MS should be counselled about these risks of abortion and followed up accordingly.
Lingua originaleEnglish
pagine (da-a)1272-1278
Numero di pagine7
RivistaJournal of Neurology, Neurosurgery and Psychiatry
Volume89
Stato di pubblicazionePublished - 2018

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Relapsing-Remitting Multiple Sclerosis
Aftercare
Inflammation
Recurrence
Pregnancy Maintenance
Gadolinium
Multicenter Studies
Therapeutics
Retrospective Studies
Pregnancy
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

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Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis. / Ragonese, Paolo; Salemi, Giuseppe; Prosperini, Luca; Mataluni, Giorgia; Landi, Doriana; Monteleone, Fabrizia; Cortese, Antonio; Ferraro, Elisabetta; Salvetti, Marco; Buscarinu, Maria Chiara; Pontecorvo, Simona; Centonze, Diego; Francia, Ada; Haggiag, Shalom; Marfia, Girolama Alessandra; Nociti, Viviana; Boffa, Laura; Mirabella, Massimiliano; Millefiorini, Enrico; Gasperini, Claudio; Fantozzi, Roberta; Pozzilli, Carlo; Di Battista, Giancarlo.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 89, 2018, pag. 1272-1278.

Risultato della ricerca: Article

Ragonese, P, Salemi, G, Prosperini, L, Mataluni, G, Landi, D, Monteleone, F, Cortese, A, Ferraro, E, Salvetti, M, Buscarinu, MC, Pontecorvo, S, Centonze, D, Francia, A, Haggiag, S, Marfia, GA, Nociti, V, Boffa, L, Mirabella, M, Millefiorini, E, Gasperini, C, Fantozzi, R, Pozzilli, C & Di Battista, G 2018, 'Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis', Journal of Neurology, Neurosurgery and Psychiatry, vol. 89, pagg. 1272-1278.
Ragonese, Paolo ; Salemi, Giuseppe ; Prosperini, Luca ; Mataluni, Giorgia ; Landi, Doriana ; Monteleone, Fabrizia ; Cortese, Antonio ; Ferraro, Elisabetta ; Salvetti, Marco ; Buscarinu, Maria Chiara ; Pontecorvo, Simona ; Centonze, Diego ; Francia, Ada ; Haggiag, Shalom ; Marfia, Girolama Alessandra ; Nociti, Viviana ; Boffa, Laura ; Mirabella, Massimiliano ; Millefiorini, Enrico ; Gasperini, Claudio ; Fantozzi, Roberta ; Pozzilli, Carlo ; Di Battista, Giancarlo. / Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis. In: Journal of Neurology, Neurosurgery and Psychiatry. 2018 ; Vol. 89. pagg. 1272-1278.
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title = "Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis",
abstract = "OBJECTIVE:To investigate clinical and radiological outcomes of women with relapsing-remitting multiple sclerosis (RRMS) undergoing abortion.METHODS:An independent, multicentre retrospective study was conducted collecting data from eight Italian MS centres. We compared the preconception and postabortion annualised relapse rate (ARR) and number of Gadolinium enhancing (Gd+) lesions, by analyses of covariance. Variables associated with postabortion clinical and MRI activity were investigated using Poisson regression models; each abortion was considered as a statistical unit.RESULTS:From 1995 to 2017, we observed 188 abortions (17 elective) in 153 women with RRMS. Abortions occurred after a mean time of 9.5 (4.4) weeks from estimated conception date. In 86 events out of 188, conception happened during treatment with disease modifying drugs. The mean postabortion ARR (0.63±0.74) was significantly increased (p=0.037) compared with the preconception year (0.50±0.71) as well as the postabortion mean number of new Gd+ lesions (0.77±1.40 vs 0.39±1.04; p=0.004). Higher likelihood of relapses was predicted by higher preconception ARR, discontinuation of preconception treatment and elective abortion; the occurrence of new Gd+ lesions was associated with higher preconception number of active lesions, discontinuation of preconception treatment, shorter length of pregnancy maintenance and elective abortion.CONCLUSIONS:Abortion was associated with clinical and radiological inflammatory rebound remarkably in the first 12 months postevent. Deregulated proinflammatory processes arising at the early stages of pregnancy might play a role both in MS reactivation and abortion. Women with MS should be counselled about these risks of abortion and followed up accordingly.",
author = "Paolo Ragonese and Giuseppe Salemi and Luca Prosperini and Giorgia Mataluni and Doriana Landi and Fabrizia Monteleone and Antonio Cortese and Elisabetta Ferraro and Marco Salvetti and Buscarinu, {Maria Chiara} and Simona Pontecorvo and Diego Centonze and Ada Francia and Shalom Haggiag and Marfia, {Girolama Alessandra} and Viviana Nociti and Laura Boffa and Massimiliano Mirabella and Enrico Millefiorini and Claudio Gasperini and Roberta Fantozzi and Carlo Pozzilli and {Di Battista}, Giancarlo",
year = "2018",
language = "English",
volume = "89",
pages = "1272--1278",
journal = "Journal of Neurology, Neurosurgery and Psychiatry",
issn = "0022-3050",
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TY - JOUR

T1 - Abortion induces reactivation of inflammation in relapsing-remitting multiple sclerosis

AU - Ragonese, Paolo

AU - Salemi, Giuseppe

AU - Prosperini, Luca

AU - Mataluni, Giorgia

AU - Landi, Doriana

AU - Monteleone, Fabrizia

AU - Cortese, Antonio

AU - Ferraro, Elisabetta

AU - Salvetti, Marco

AU - Buscarinu, Maria Chiara

AU - Pontecorvo, Simona

AU - Centonze, Diego

AU - Francia, Ada

AU - Haggiag, Shalom

AU - Marfia, Girolama Alessandra

AU - Nociti, Viviana

AU - Boffa, Laura

AU - Mirabella, Massimiliano

AU - Millefiorini, Enrico

AU - Gasperini, Claudio

AU - Fantozzi, Roberta

AU - Pozzilli, Carlo

AU - Di Battista, Giancarlo

PY - 2018

Y1 - 2018

N2 - OBJECTIVE:To investigate clinical and radiological outcomes of women with relapsing-remitting multiple sclerosis (RRMS) undergoing abortion.METHODS:An independent, multicentre retrospective study was conducted collecting data from eight Italian MS centres. We compared the preconception and postabortion annualised relapse rate (ARR) and number of Gadolinium enhancing (Gd+) lesions, by analyses of covariance. Variables associated with postabortion clinical and MRI activity were investigated using Poisson regression models; each abortion was considered as a statistical unit.RESULTS:From 1995 to 2017, we observed 188 abortions (17 elective) in 153 women with RRMS. Abortions occurred after a mean time of 9.5 (4.4) weeks from estimated conception date. In 86 events out of 188, conception happened during treatment with disease modifying drugs. The mean postabortion ARR (0.63±0.74) was significantly increased (p=0.037) compared with the preconception year (0.50±0.71) as well as the postabortion mean number of new Gd+ lesions (0.77±1.40 vs 0.39±1.04; p=0.004). Higher likelihood of relapses was predicted by higher preconception ARR, discontinuation of preconception treatment and elective abortion; the occurrence of new Gd+ lesions was associated with higher preconception number of active lesions, discontinuation of preconception treatment, shorter length of pregnancy maintenance and elective abortion.CONCLUSIONS:Abortion was associated with clinical and radiological inflammatory rebound remarkably in the first 12 months postevent. Deregulated proinflammatory processes arising at the early stages of pregnancy might play a role both in MS reactivation and abortion. Women with MS should be counselled about these risks of abortion and followed up accordingly.

AB - OBJECTIVE:To investigate clinical and radiological outcomes of women with relapsing-remitting multiple sclerosis (RRMS) undergoing abortion.METHODS:An independent, multicentre retrospective study was conducted collecting data from eight Italian MS centres. We compared the preconception and postabortion annualised relapse rate (ARR) and number of Gadolinium enhancing (Gd+) lesions, by analyses of covariance. Variables associated with postabortion clinical and MRI activity were investigated using Poisson regression models; each abortion was considered as a statistical unit.RESULTS:From 1995 to 2017, we observed 188 abortions (17 elective) in 153 women with RRMS. Abortions occurred after a mean time of 9.5 (4.4) weeks from estimated conception date. In 86 events out of 188, conception happened during treatment with disease modifying drugs. The mean postabortion ARR (0.63±0.74) was significantly increased (p=0.037) compared with the preconception year (0.50±0.71) as well as the postabortion mean number of new Gd+ lesions (0.77±1.40 vs 0.39±1.04; p=0.004). Higher likelihood of relapses was predicted by higher preconception ARR, discontinuation of preconception treatment and elective abortion; the occurrence of new Gd+ lesions was associated with higher preconception number of active lesions, discontinuation of preconception treatment, shorter length of pregnancy maintenance and elective abortion.CONCLUSIONS:Abortion was associated with clinical and radiological inflammatory rebound remarkably in the first 12 months postevent. Deregulated proinflammatory processes arising at the early stages of pregnancy might play a role both in MS reactivation and abortion. Women with MS should be counselled about these risks of abortion and followed up accordingly.

UR - http://hdl.handle.net/10447/358419

M3 - Article

VL - 89

SP - 1272

EP - 1278

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

SN - 0022-3050

ER -