# Four years on: Pregnancy and birth outcomes reported in the MSBase pregnancy, neonatal outcomes, and Women’s Health Registry (2020–2024)

## TL;DR

This study tracks pregnancy and birth outcomes in women with MS and NMOSD from 2020 to 2024, finding mostly safe results despite DMT use.

## Contribution

The first report from the MSBase pregnancy registry provides real-world data on perinatal DMT exposure and pregnancy outcomes.

## Key findings

- Most pregnancies involved DMT exposure within six months preconception, with no overt safety signals observed.
- 18.1% of pregnancies reported in-pregnancy monoclonal antibody DMT exposure.
- Live birth rates were high (85.5%), with most births occurring via unassisted or assisted vaginal delivery.

## Abstract

Family planning is an important aspect of multiple sclerosis (MS), and neuromyelitis optica spectrum disorder (NMOSD) management. Knowledge gaps remain, including optimal perinatal management strategies, and fetal risks associated with disease-modifying therapy (DMT) exposure.

To describe perinatal DMT use, together with pregnancy and neonatal outcomes prospectively recorded in the International MSBase Pregnancy and Women’s Health Registry.

We report summary statistics for data collected between May 2020 and August 2024.

A total of 1887 relapsing-remitting MS (RRMS), 12 primary-progressive MS (PPMS), 2 radiologically isolated syndrome (RIS) and 21 NMOSD completed pregnancies were recorded, including 1644 (85.5%) live births, 208 (10.8%) miscarriages, and 6 (0.3%) neonatal deaths. Most women had unassisted (53.8%) or assisted (7.4%) vaginal births. Seventy five percent of pregnancies had DMT exposures within 6 months preconception; 19% of NMOSD, and 62% of MS pregnancies were DMT-exposed during gestation; 18.1% of pregnancies reported in-pregnancy monoclonal antibody DMT exposure. No overt safety signals were seen.

This first report from the newly launched MSBase pregnancy registry, establishes an increasing number of pregnancies being conceived on monoclonal antibody therapies. Although no safety signals were observed, it is important to continue monitoring for safety signals in real-world databases as the use of highly effective therapies continues to increase perinatally.